Limbs 1 Flashcards
What are the two major structures of the body?
- main body (head, neck and trunk)
- appendages (upper and lower limbs)
What are the two major structures of the skeleton?
- axial skeleton (head, neck and trunk)
- appendicular skeleton (upper and lower limbs)
What does the appendicular skeleton consist of?
- upper and lower limb bones
- bones of the pectoral and pelvic girdle
What is the function of the upper limb?
position the hand for manipulation and grip activities
What is the function of the lower limb?
support the body weight, locomotion, maintain balance
Which joints connect the upper limbs to the trunk?
- sternoclavicular joints (true joints)
- scapulo-thoracic joints (virtual joints)
Which joints connect the lower limbs to the trunk
Sacroiliac joints (between the pelvis and sacrum)
What are the four regions of the upper limb?
- The pectoral (shoulder) girdle
- The arm
- The forearm
- The hand
What are the pectoral girdle bones?
Clavicle and scapula
What is the arm bone?
The humerus
What are the forearm bones?
The radius and ulna
What are the wrist bones?
Carpal bones
What are the bones of the main part of the hand?
Metacarpals
What are the bones of the digits, including the thumb?
Phalanges
What are the articulations of the clavicle?
- Medial end articulates with the thoracic wall of the trunk at the manubrium
- Lateral end articulates with the scapular acromion
What is the clavicle?
- moveable structure which supprts the scapula and upper limb
- site of muscle attachment
Label this diagram of the clavicle
- Acromial end
- Shaft
- Sternal end
- Sternal facet
- Impression for costoclavicular ligament
- Subclavian groove
- Trapezoid line
- Acromial facet
- Conoid tubercle
What is the scapula?
- shoulder blade
- triangular plate of bone
- various bony features and fossae which act as sites of attachment for muscles and ligaments
Label this diagram of the scapula
- Supraspinous fossa
- Scapular spine
- Acromion
- Glenoid fossa
- Infraspinous process
- Subscapular fossa
- Coracoid process
What can be seen on the scapula’s anterior view?
- acromion
- coracoid process
- glenoid fossa
- subscapular fossa
What can be seen on the scapula’s posterior view?
- supraspinous fossa
- scapular spine
- acromion
- glenoid fossa
- infraspinous fossa
What is the glenoid fossa?
Socket of the shoulder joint
What does the acromion articulate with?
The clavicle
What does the glenoid fossa articulate with?
Humoural head
What is the scapula held against?
The posterolateral thoracic wall
What is the humerus?
largest bone of the upper limb
What does the humerus articulate with?
- glenoid fossa proximally to form shoulder joint
- radius and ulna distally to form elbow joint
Label this diagram of the humerus
- Greater tubercle
- Intertubercular sulcus
- Lesser tubercle
- Lateral epicondyle
- Humerus shaft
- Medial epicondyle
- Deltoid tuberosity
- Radial groove
What connects the inner shafts of the radius and ulna?
Intraosseous membrane
What do the radius and ulna articulate with?
- humerus proximally
- carpal bones distally
How many rows of carpal bones are there and how many bones are in each row?
Two rows of four
What do the carpal bones articulate with?
- proximal row (apart from pisiform) with radius and ulna
- distal row with metacarpals
How are joints classified?
- strucutal properties
- mobility
What are the three structural classifications of joints?
- fibrous
- cartilaginous
- synovial
What are fibrous joints?
bones connected by fibrous connective tissue, e.g. sutures of skull
What are cartilaginous joints?
bones connected with cartilage, e.g. pubic symphysis
What are the two types of cartilaginous joints?
- primary (hyaline cartilage)
- secondary (fibrocartilage)
What are synovial joints?
- bones not directly connected at joint surfaces
- articulation is surrounded by enclosing synovial capsule
- generally covered in hyaline cartilage
What are the different types of synovial joints?
- uniaxial (moves in one direction)
- biaxial (moves in two planes)
- multiaxial (moves in several planes)
What is the relationship between joint mobility and stability?
The more mobile a joint, the less stable it usually is
Which other structures provide stability to joints?
Ligaments and tendons
What is a ligament?
collagenous connective tissue linking bones
What is a tendon?
collagenous connective tissue between bones and muscles
What is a retinaculum?
- thickened band of deep fascia found close to a joint
- holds tendons down during muscle contraction to prevent bow-stringing
What is an aponeurosis?
- a flat, sheet-like structure formed from a tendon or ligament
- can provide a broad attachment for a muscle which will distribute mechanical load over a larger area
What is a bursa?
- a closed sac of a serous membrane
- found at body sites that are subject to friction
What are the joints of the upper limb?
- Sterno-clavicular joint (SCJ)
- Acromio-clavicular joint (ACJ)
- Gleno-Humeral joint (GHJ) (Shoulder joint)
- Scapulo-thoracic joint (STJ)
- Elbow joint
- Wrist joint
- Numerous joints in the hand
Describe the sternoclavicular joint
- synovial saddle joint
joint cavity divided by fibrous articular disc - stabilised with a number of ligaments
- significant mobility during clavicle elevation and protraction/retraction of the scapula
Decribe the acromioclavicular joint
- plane synovial joint between the lateral end of the clavicle and the acromion
- rotation and some
vertical and anterior/posterior (A/P) movements
Describe the glenohumeral joint
- ball-and-socket synovial joint
- glenoid fossa is shallow, but slightly deepened by a cartilaginous labrum
- highly mobile joint with wide range of movement
- muscles required for joint stability
Describe the elbow joint
- synovial hinge joint
- allows for flexion and extension of forearm
Label the carpal bones
- Scaphoid
- Lunate
- Triquetrium
- Pisiform
- Trapezium
- Trapezoid
- Capitate
- Hamate
Which carpal bones form the wrist joint at the articular disc?
- scarphoid carpal bone
- lunate carpal bone
- triquetrum carpal bone
What do the radius and ulna articulate with to form the wrist joint?
- radius = articular disc
- ulna = distal radio-ulnar joint (just proximal to wrist joint)
What happens to the articular disc during pronation/supination?
Slides over the distal end of the ulna
How many phalages does each digit have?
3 (aside from thumb, which has 2)
What are the joints between the two rows of carpal bones?
Intercarpal joints
What are the joints between the distal row of carpal bones and metacarpal bones?
Carpometacarpal joints
What are the joints between the metacarpals and phalanges called?
Metacarpophalangeal joints
What are the joints between the proximal and middle phalanges called?
Proximal interphalagneal joints
What are the joints between the middle and distal phalanged called?
Distal interphalangeal joints
What are the limb muscles divided into?
Compartments with:
- distinct function
- same nerve supply
- same blood supply
- connective tissue sepatae to separate them
What are the compartments of the upper limb?
- Pectoral girdle muscles
- Intrinsic shoulder muscles
- Anterior arm muscles
- Posterior arm muscles
- Anterior forearm muscles
- Posterior forearm muscles
- Intrinsic hand muscles
Which upper limb muscles are flexors?
- anterior arm muscles
- anterior forearm muscles
Which arm muscles are extensors?
- posterior arm muscles
- posterior forearm muscles
Which muscles compartments act on the shoulder?
- pectoral girdle muscles
- intrinsic shoulder muscles
Which muscles form the pectoral girdle?
- trapezius
- latissimus dorsi
- serratus anterior
- pectoralis major
Which muscles form the intrinsic shoulder muscles?
- deltoid
- teres major
- roatator cuff muscles
What are the rotator cuff muscles?
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
What is the function of the intrinsic shoulder muscles?
- move the humerus at the shoulder joint
- stabilise the shoulder joint by holding the humeral head in the glenoid fossa
Lable this diagram of the pectoral girlde
- Serratus anterior
- Pectoralis major
- Trapezius
- Latissimus dorsi
Label this diagram of the intrinsic shoulder muscles
- Deltoid
- Rotator cuff muscles
- Teres major
What are the anterior muscles of the arm?
- biceps brachii
- coracobrachialis
- brachialis
What are the posterior muscles of the arm?
- triceps brachii
- anconeus
What are the attachments of the deep forearm muscles?
- distal humerus
- radius and ulna
- interosseous membrane
What are the three compartments of the forearm?
- superficial flexor
- deep flexor
- extensor
(Forearm) muscle terminology
What does flexor mean?
flexes at a joint
(Forearm) muscle terminology
What does extensor mean?
Extends at a joint
(Forearm) muscle terminology
What does capri mean?
Acts across the wrist
(Forearm) muscle terminology
What does radialis mean?
Acts of the radial aspect of the wrist
(Forearm) muscle terminology
What does ulnaris mean?
Acts on the ulnar aspect of the wrist
(Forearm) muscle terminology
What does digitorum mean?
Acts on a group of digits (excluding thumb)
(Forearm) muscle terminology
What does pollicis mean?
Acts only on thumb
(Forearm) muscle terminology
What does digiti minimi mean?
Acts only on the little finger
(Forearm) muscle terminology
What does indicis mean?
Acts only on index finger
(Forearm) muscle terminology
What do longus and brevis mean?
Long and short
(Forearm) muscle terminology
What do superficialis and profundus mean?
Superficial and deep
What is the thenar eminence of the hand?
prominence between the base of the thumb and the wrist containing small muscles acting on the thumb
What is the hypothenar eminence of the hand?
prominence between the base of the little finger and the wrist containing small muscles acting on the little finger
What are the different intrinsic muscle groups of the hand?
- thenar muscles
- adductor muscles
- hypothenar muscles
- interossei and lumbrical
What do the four lumbrical muscles do?
- flex metacarpal joints
- extend interphalageal joints
What do the three palmar interossei muscles do?
Adduct the digits (PAD)
What do the four doral interossei muscles do?
Abduct the digits (DAB)
Label the anterior arm muscles
- Biceps brachii
- Coracobrachialis
- Brachialis
Label this diagram of the proximal humerus
- Anatomical neck
- Greater tuberosity
- Surgical neck
- Humeral head
- Intertubercular groove
- Lesser tuberosity
- Deltoid tuberosity
Label this diagram of the distal humerus
- Olecranon fossa
- Lateral epicondyle
- Trochlea
- Medial epicondyle
- Coronoid fossa
- Radial fossa
- Capitulum
Label this diagram of the bony landmarks of the radius and ulna
- Head of radius
- Radial tuberosity
- Olecranon
- Trochlear notch
- Coronoid process
What is the origin and insertion of the trapezius?
- origin = skull, spinous process C7-T12
- insertion = clavicle, acromion and scapular spine
- action = elevates shoulder by rotating the scapula
What is the origin, insertion and action of the latissimus dorsi?
- origin = spinous process T7-T12
- insertion = intertubercular sulcus of the humerus
- action, action = extension, adduction and medial rotation at shoulder
What is the axilla?
Armpit
What are the six boundaries of the axilla?
• Anterior wall - pectoralis major and minor
• Posterior wall - subscapularis, teres major and latissimus dorsi
• Lateral wall - intertubercular groove of humerus
• Medial wall - serratus anterior and thoracic wall
• Apex - clavicle, first rib and scapula. It is the passage between the neck and axilla.
• Base - skin and fascia between the thoracic wall and arm
What is the origin and insertion of the long head of the biceps brachii?
- origin = supraglenoid tubercle
- insertion = bicipital tendon to radial tuberosity and bicipital apomeurosis to cubital fossa
What are the two heads of the biceps brachii and where do they join?
- short and long head
- fuse into bicipital tendon
What is the origin and insertion of the brachialis?
- origin = shaft of humerus
- insertion = coronoid process of ulna
What is the origin and insertion of the coracobrachialis?
- origin = coracoid process of the scapula
- insertion = shaft of humerus
What are the three heads of the triceps brachii and what do they form?
- long, medial and lateral head
- fuse into triceps tendon
What is the origin and insertion of the long head of the triceps brachii?
- origin = infraglenoid tubercle
- insertion = triceps tendon to the olecranon of the ulna
What is the origin and insertion of the medial and lateral heads of the triceps brachii?
- origin = humeral shaft
- insertion = triceps tendon
Label this diagram of the glenohumeral joint
- Clavicle
- Acromioclavicular joint
- Acromion
- Humerus
What is 6?
Glenoid cavity
What are the four forearm muscles in the superficial layer from lateral to medial?
- Protonator teres
- Flexor carpi radialis
- Palmaris longus
- Flexor carpi ulnaris
What is the origin of the superficial forearm muscles?
Common flexor origin at medial epicondyle or humerus
What are the three deep anterior forearm muscles?
What is the intermediate forearm muscle?
Flexor digitorum superficialis
What are the three borders of the cubital fossa?
- lateral = bracioradialis (posterior forearm muscle)
- medial = pronatar teres
- superior = line between lateral and medial epicondyle of humerus
What is the origin of the posterior forearm muscles?
- common extensor origin
- found at lateral epicondyle of humerus for all muscles except brachioradialis and extensor carpi radialis longus
Label this diagram of the elbow joint
- Head of radius
- Capitulum
- Medial epicondyle
- Coranoid process
- Olecranon
Describe the wrist joint
- radiocarpal joint
- synovial joint
- between proximal carpal bones and distal ends of radius and ulna
What are the attachments of the extrinsic hand muscles?
- proximal = forearm
- distal = hand
What are the attachements of the intrinsic muscles of the hand?
Both proximal and distal in hand
Label this diagram
- Hypothenar eminence
- Thenar eminence
- Lumbricals
- Dorsal interossei
- Palmar interossei
