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FOCA > Module 2: Upper Limb > Flashcards

Module 2: Upper Limb Flashcards

1
Q

what is the rib span of the scapula?

A

2nd -7th rib

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2
Q

acromial facet of the clavicle

A

area that articulates w/ acromion of the scapula

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3
Q

pectoralis major

A
  1. proximal attachment: ant. med. surface of clavicle, lateral edge of sternocostal head (superior 6 cartilages)
  2. distal attachment: lateral lip of intertubercular sulcus of humerus. clavicular head
  3. innervation: lateral and medial pectoral nerves, (C5, C6), sternocostal head (C7, C8, T1)
  4. action: adducts and medially rotates shoulder joint, draws scapula anteriorly and inferiorly.
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4
Q

pectoralis minor

A
  1. proximal attach: 3rd-5th ribs near costal cartilages.
  2. distal attach: medial border and superior surface of coracoid process of scapula.
  3. innervation: medial pectoral nerve (C8, T1)
  4. action: stabilizes scapula by drawing inferiorly and anteriorly against thoracic wall.
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5
Q

serratus anterior

A
  1. prox. attach: external surfaces of lateral parts of 1st-8th ribs.
  2. dist. attach: ant. surface of med. border of scapula.
  3. innervation long thoracic nerve (C5, C6, C7)
  4. action: protract scap. and holds against thoracic wall; rotates scapula.
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6
Q

lateral pectoral nerve

A

nerve of the BP. comes off of lateral cord which is on the superior trunk of the BP. innervates pectoralis major, some nerve fibers pass to pec. minor via branch to medial pectoral nerve. C5, C6, C7.

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7
Q

medial pectoral nerve

A

nerve of the BP. comes of anterior division of the inferior trunk of the BP. innervates pectoralis minor and substernal costal part of pec. major. C8, T1.

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8
Q

Colles fracture

A

fracture of the distal 2cm of the radius, often due to falling on extended wrists, very common in folks >50 (or anyone)

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9
Q

scaphoid fracture

A

fracture of the scaphpoid. pain in the lateral side of the wrist, dangerous because may lead to avascular necrosis of the proximal fragment of the scaphoid, BAD NEWS. check the snuffbox everyone.

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10
Q

deltoid proximal attachment (origination)

A

clavicular part, acromial part, scapular part (SAC)

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11
Q

deltoid distal attachment (insertion)

A

deltoid tuberosity of the humerus

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12
Q

innervation of deltoid muscle

A

axillary nerves (C5-C6)

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13
Q

supraspinatous proximal attachment (origination)

A

supraspinous fossa of the scapula

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14
Q

supraspinatous distal attachment (insertion)

A

superior facet of the greater tubercle of humerus

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15
Q

supraspinatous innervation

A

suprascapular nerve (C4-C6)

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16
Q

infraspinatus proximal attachment (origination)

A

infraspinous fossa of the scapula

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17
Q

infraspinatus distal attachment (insertion)

A

middle facet of the greater tubercle of the humerus

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18
Q

innervation of the infraspinatus

A

suprascapular nerve (C5, C6)

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19
Q

teres minor proximal attachment

A

lateral side of the scapula

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20
Q

teres minor distal attachment

A

inferior facet of the greater tubercle of the humerus

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21
Q

teres minor innervation

A

axillary nerve (C5, C6)

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22
Q

teres major proximal attachment

A

inferior part of the lateral border of scapula and posterior surface of the inferior angle of scapula

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23
Q

teres major distal attachment

A

medial lip of intertubercular sulcus of humerus

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24
Q

teres major innervation

A

lower subscapular nerve (C5, C6)

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25
Q

subscapularis proximal attachment

A

subscapular fossa (most anterior surface of scapula)

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26
Q

subscapularis distal attachment

A

lesser tubercle of the humerus

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27
Q

subscapularis innervation

A

upper and lower subscapular nerves (C5-C7)

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28
Q

subscapularis action

A

internally rotates upper arm

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29
Q

teres major action

A

adducts and medially rotates shoulder

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30
Q

teres minor action

A

laterally rotates shoulder w/ infraspinatous, helps hold humeral head in glenoid cavity of scapula

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31
Q

infraspinatous action

A

laterally rotates shoulder w/ teres minor, helps hold humeral head in glenoid cavity of scapula

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32
Q

supraspinatous action

A

initiates and assists deltoid in abduction of shoulder, acts w/ other rotator cuff muscles

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33
Q

deltoid action

A

clavicular part flexes and medially rotates shoulder joint; acromial part abducts shoulder joint; spinal part extends and laterally rotates shoulder joint

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34
Q

what nerve passes through the carpal tunnerl

A

medial nerve

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35
Q

posterior triangle

A

area of the lateral cervical region where the brachial plexus begins

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36
Q

what rami make up the roots of the BP?

A

ventral rami of C5-T1

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37
Q

dorsal scapular nerve ramus number

A

C5

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38
Q

what vascular landmarks in the posterior triangle can help you identify the roots of the BP?

A

subclavian vein and the subclavian artery

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39
Q

structures innervated by the dorsal scapular nerve

A

rhomboids (sometimes levator scapulae)

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40
Q

structures innervated by the suprascapular nerve

A

supraspinatus and infraspinatus; blenohumeral joint

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41
Q

structures innervated by the lateral pectoral nerve

A

pectoralis major

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42
Q

structures innervated by the long thoracic nerve

A

serratus anterior

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43
Q

structures innervated by the upper subscapular nerve

A

superior portion of the subscapularis

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44
Q

structures innervated by the thoracodorsal nerve

A

latissimus dorsi

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45
Q

structures innervated by the lower subscapularis nerve

A

inferior portion of subscauplaris and teres major

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46
Q

structures innervated by the medial pectoral nerve

A

pectoralis minor and part of pectoralis major

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47
Q

structures innervated by the medial brachial cutaneous nerve

A

skin of medial side of arm, as far distal as the medial epicondyle of the humerus and olecranon of ulna

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48
Q

structures innervated by the medial antebrachial cutaneous nerve

A

skin of medial side of forearm (as far distal as wrist)

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49
Q

structures innervated by the medial antebrachial cutaneous nerve

A

skin of medial side of forearm (as far distal as wrist)

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50
Q

structures innervated by the musculocutaneous nerve

A

muscles of the anterior compartment of the arm (coracobrachialis, biceps brachii, and brachialis); skin of lateral aspect of forearm

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51
Q

cord that leads to MC nerve

A

lateral

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52
Q

rami of the median nerve

A

C6, C7, C8, T1

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53
Q

cord that leads to the median nerve

A

both lateral and medial cords

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54
Q

rami of the ulnar nerve

A

C8, T1

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55
Q

cord that leads to the ulnar nerve

A

medial

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56
Q

rami of the radial nerve

A

C5, C6, C7, C8

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57
Q

cord that leads to the radial nerve

A

posterior

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58
Q

rami of the axillary nerve

A

C5, C6

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59
Q

cord that leads to the axillary nerve

A

posterior

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60
Q

cord that leads to the axillary nerve

A

posterior

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61
Q

structures innervated by the median nerve

A

muscles of the anterior forearm compartment (except for flexor carpi ulnaris and ulnar half of flexor digitorium profundus), five intrinsic muscles of palm and palmar skin

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62
Q

structures innervated by the ulnar nerve

A

flexor carpi ulnaris and ulnar half of flexor digitorum profundus (forearm); most intrinsic muscles of hand; skin of the hand medial to axial line of digit 4.

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63
Q

what are the “one and a half” anterior muscles of the forearm that are innervated by the ulnar nerve?

A

FCU (flexor carpi ulnaris) and part of FDP (flexor digitorum profundus)

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64
Q

structures innervated by the radial nerve

A

all muscles of posterior compartments of arm and forearm; skin of posterior and inferolateral arm, posterior forearm , and dorsum of hand lateral to axial line of digit 4

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65
Q

which is the more lateral head of the biceps brachii?

A

long head (Long Lateral)

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66
Q

structures innervated by the axillary nerve

A

glenohumeral joint, teres minor, deltoid, skin of superolateral arm (skin over deltoid)

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67
Q

what are the 5 groups of axillary lymph nodes?

A

HCASP (clockwise, starting from top left- 1-3 are in line with the axillary vein)

  1. humeral (lateral)
  2. central l
  3. apical
  4. subscapular (posterior)
  5. pectoral
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68
Q

deltopectoral groove

A

surface anatomy, triangular groove inferior to the middle portion of the clavicle. marks the area where the large vessels and brachial plexus are underneath the skin. formed by the clavicle superiorly, the deltoid laterally, the clavicular head of the pectoralis major medially.

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69
Q

location/span of axillary artery

A

begins at lateral border of 1st rib, continuation of subclavian artery, ends at inferior border of teres major. passes post. to pec. minor. becomes brachial art. when it passes distal to inferior border of teres major.

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70
Q

name the branches of the 1st part of the axillary artery

A

superior thoracic artery

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71
Q

name the branches of the 2nd part of the axillary artery

A

thoraco-acromial artery

lateral thoracic artery

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72
Q

name the branches of the 3rd part of the axillary artery

A

subscapular artery (largest branch of axillary artery)
anterior circumflex humeral artery
posterior circumflex humeral artery
(SAP)

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73
Q

name the first layer of antebrachial flexors (medial to lateral)

A

flexor carpi ulnaris
palmaris longus
flexor carpi radialis
brachialis

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74
Q

flexor carpi ulnaris proximal attachment

A

olecranon and posterior border of ulna (via aponeurosis)

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75
Q

flexor carpi ulnaris distal attachment

A

pisiform, hook of hamate, 5th metacarpal

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76
Q

coronoid process of the ulna

A

proximal portion of ulna, fits into the coronoid fossa

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77
Q

location of the head of the ulna

A

lateral aspect of the most distal area of the ulna

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78
Q

location of the head of the radius

A

most proximal part of the radius

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79
Q

location of the tuberosity of radius

A

proximal, medial on the radius

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80
Q

location of the tuberosity of ulna

A

superior to the tuberosity of the radius. proximal, lateral on the ulna

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81
Q

locations of the styloid processes of the radius and ulna

A

both are located distally

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82
Q

olecranon

A

portion of the ulna that articulates w/ the humerus posteriorly between the medial and lateral epicondyles

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83
Q

location of the radial notch of the ulna

A

lateral side of the coronoid process, smooth rounded concavity that articulates w/ the head of the radius

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84
Q

location of the ulnar notch of the radius

A

medial aspect of distal end, concavity that articulates w/ the head of the ulna

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85
Q

deltoid tuberosity

A

tuberosity on the mid/superior aspect of the lateral humerus. distal attachment site of the deltoid

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86
Q

what is the area between the two tubercles on the humerus called?

A

intertubercular suclcus

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87
Q

what are the names of the two fossa at the anterior, distal site of the humerus?

A

laterally: radial fossa
medially: coronoid fossa

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88
Q

location of the dorsal tubercle of the radius

A

distal, dorsal, medial to the styloid process of the radius

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89
Q

location of the anatomical neck of the humerus

A

area that articulates w/ glenoid cavity

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90
Q

location of the surgical neck of the humerus

A

inferior to the greater and lesser tuberosities, still located proximally on the humerus

91
Q

name the two prominent features on the shaft of the humerus

A 
deltoid tuberosity (laterally)
radial (spiral) groove (posteriorly)
92
Q

function of the radial (spiral) groove and its location

A

carries the radial nerve, posterior on the shaft of the humerus

93
Q

location of the supracondylar ridges

A

proximally on either side of the humerus, superior to the condyles

94
Q

what structures make up the condyles of the humerus?

A
  1. capitulum (laterally-articulates w/ head of radius)
  2. trochlea (medially-articulates w/ coronoid process of ulna)
  3. olecranon fossa (posteriorly)
  4. coronoid fossa (superior to trochlea)
  5. radial fossa (superior to the capitulum)
95
Q

carpals

A

bones of the wrist

96
Q

metacarpals

A

bones of the hand

97
Q

phalanges

A

bones of the fingers

98
Q

innervation of the flexor carpi ulnaris

A

ulnar nerve

99
Q

biceps brachii proximal attachment

A

short head: coracoid process

long head: supraglenoid tubercle of scapula

100
Q

biceps brachii distal attachment

A

tuberosity of the radius and the facial of the forearm va bicipital aponeurosis

101
Q

innervation of the biceps brachii

A

musculocutaneous nerve

102
Q

brachialis proximal attachment

A

distal half of anterior surface of the humerus

103
Q

brachialis distal attachment

A

coronoid process and the tuberosity of the ulna

104
Q

function of the biceps brachii

A

flex elbow and supinate forearm

105
Q

brachialis innervation

A

musculocutaneous

106
Q

brachialis function

A

flexes elbow joint

107
Q

coracobrachialis proximal attachment

A

tip of coracoid process of scapula

108
Q

coracobrachialis distal attachment

A

middle third of medial surface of the humerus

109
Q

coracobrachialis innervation

A

musculocutaneous

110
Q

coracobrachialis function

A

flex and adduct shoulder

111
Q

triceps brachii proximal attachment

A

long head: infraglenoid tubercle of scapula
lateral head: posterior surface of the humerus superior to radial groove
medial head: posterior surface of the humerus, inferior to radial groove

112
Q

triceps brachii distal attachment

A

proximal end of olecranon of ulna and fascia of forearm

113
Q

triceps brachii innervation

A

radial nerve

114
Q

triceps brachii function

A

chief extensor of elbow

115
Q

what is the function of the brachial fascia?

A

separates the anterior and posterior compartments of the arm

116
Q

which is more lateral at the level of the biceps brachii: musculoculatenous nerve or median nerve?

A

median nerve

117
Q

what nerve contributes to the innervation of all deep extensor antebrachial muscles?

A

radial nerve

118
Q

brachioradialis origin

A

humerus (lateral supercondyle area)

119
Q

brachioradialis insertion

A

stylus of the radius

120
Q

brachioradialis innervation

A

radial nerve

121
Q

brachioradialis action

A

flexes the forearm

122
Q

name the superficial muscles of the extensor forearm

A
  1. brachioradialis
  2. extensor carpi radialis longus
  3. extensor carpi radialis brevis
  4. extensor digitorum
  5. extensor digiti minimi
  6. extensor carpi ulnaris
123
Q

name the deep muscles of the extensor forearm

A
  1. supinator
  2. abductor pollicis longus
  3. extensor pollicis brevis
  4. extensor pollicis longus
  5. extensor indicis
124
Q

which muscles of the extensor forearm wrap over the extensor carpi radialis longus and the extensor carpi radialis brevis?

A

abductor pollicis longus (proximal)

extensor pollicis brevis (distal)

125
Q

which is more lateral: extensor carpi radialis longus or extensor carpi radialis brevis?

A

extensor carpi radialis longus

126
Q

extensor carpi radialis longus proximal attachment

A

lateral supercondylar ridge of the humerus

127
Q

extensor carpi radialis longus distal attachment

A

on the radial side of the base of 2nd metacarpals

128
Q

extensor carpi radialis longus innervation

A

radial nerve

129
Q

extensor carpi radialis brevis proximal attachment

A

lateral condyle of the humerus

130
Q

extensor carpi radialis brevis distal attachment

A

on the radial side of the base of the 3rd metacarpals

131
Q

extensor carpi radialis brevis innervation

A

deep branch of the radial nerve

132
Q

extensor carpi radialis longus/brevis action

A

extend and abduct wrist joint

133
Q

extensor digitorum proximal attachment

A

lateral condyle of the humerus

134
Q

which four extensor forearm muscles attach at the lateral condyle of the humerus?

A
  1. extensor digitorum radialis brevis
  2. extensor digitorum
  3. extensor digiti minimi
  4. extensor carpi ulnaris
135
Q

extensor digitorum distal attachment

A

extensor expansions of the medial four fingers

136
Q

extensor digitorum innervation

A

posterior interosseous nerve

137
Q

posterior interosseous nerve origination

A

originates from the deep radial nerve after it passes the supinator muscle

138
Q

extensor digitorum action

A

extends wrist joint, extends medial four fingers

139
Q

extensor digiti minimi proximal attachment

A

lateral epicondyle of the humerus

140
Q

extensor digiti minimi distal attachment

A

extensor expansion of the 5th finger

141
Q

extensor digiti minimi innervation

A

posterior interosseous nerve

142
Q

extensor carpi ulnaris proximal attachment

A

has 2 heads!

lateral condyle of the humerus; posterior border of ulna via shared aponeurosis

143
Q

extensor carpi ulnaris distal attachment

A

dorsal aspect of the base of the 5th metacarpal

144
Q

extensor carpi ulnaris innervation

A

posterior interosseous nerve

145
Q

extensor carpi ulnaris action

A

extends and adducts wrist joint

146
Q

supinator proximal attachment

A

supinator crest of ulna

147
Q

supinator distal attachment

A

lateral radius (and radial collateral ligament)

148
Q

supinator innervation

A

deep radial nerve (as DRN passes supinator it becomes the posterior interosseous nerve)

149
Q

abductor pollicis longus proximal attachment

A

interosseous membrane and ulna and radius

150
Q

abductor pollicis longus distal attachment

A

base of 1st phalanges

151
Q

abductor pollicis longus innervation

A

posterior interosseous nerve

152
Q

extensor pollicis brevis proximal attachment

A

interosseous membrane and posterior surface of distal radius (BREVIS attaches to RADIUS)

153
Q

extensor pollicis brevis distal attachment

A

base of 1st proximal phalanx

154
Q

extensor pollicis brevis innervation

A

posterior interosseous nerve

155
Q

extensor pollicis longus proximal attachment

A

interosseous membrane and posterior surface of ulna (LONGUS attaches to ULNA)

156
Q

extensor pollicis longus distal attachment

A

base of 1st distal phalanx

157
Q

extensor pollicis longus innervation

A

posterior interosseous nerve

158
Q

extensor indicis proximal attachment

A

posterior surface of the distal third of ulna and interosseous memembrane

159
Q

extensor indicis innervation

A

poserior interosseous nerve

160
Q

name the superficial flexor muscles of the forearm

A
  1. pronator teres
  2. flexor carpi radialis
  3. palmarus longus
  4. flexor carpi ulnaris
161
Q

name the intermediate flexor muscles of the forearm

A
  1. flexor digitorum superficialis
162
Q

name the deep flexor muscles of the forearm

A
  1. flexor digitorum profundus
  2. flexor pollicis longus
  3. pronator quadratus
163
Q

what muscles of the anterior forearm originate at the common flexor tendon?

A
  1. flexor carpi ulnaris
  2. flexor carpi radialis
  3. pronator teres
  4. palmaris longus
  5. flexor digitorum superficialis
    * *all superficial and intermediate muscles of the anterior forearm originate at the CFT
164
Q

pronator teres distal attachment

A

middle convexity of lateral surface of the radius

165
Q

pronator teres innervation

A

median nerve

166
Q

pronator teres action

A

pronates and flexes forearm

167
Q

flexor carpi radialis origination

A

CFT at the medial epicondyle of humerus

168
Q

pronator teres origination

A

CFT at the medial epicondyle of humerus

169
Q

flexor carpi radialis distal attachment

A

base of 2nd metacarpal

170
Q

flexor carpi radialis innervation

A

median never

171
Q

palmaris longus origination

A

CFT at medial epicondyle of humerus

172
Q

palmaris longus insertion

A

distal halft of flexor retinaculum, palmar aponeurosis

173
Q

palmaris longus innervation

A

median nerve

174
Q

flexor carpi ulnaris origination

A

2 heads!

humeral and ulnar heads. olecranon and posterior border of ulna via apnoeurosis

175
Q

flexor carpi ulnaris insertion

A

pisiform, hook of hamate, 5th metacarpal

176
Q

flexor carpi ulnaris innervation

A

ulnar nerve

177
Q

flexor carpi ulnaris action

A

flexes and adducts hand at wrist

178
Q

flexor digitorum superficialis proximal attachment

A

CFT of medial condyle of humerus

179
Q

flexor digitorum superficialis distal attachment

A

shafts of middle phalanges of medial 4 digits

180
Q

flexor digitorum superficialis innervation

A

median nerve

181
Q

flexor digitorum profundus origin

A

(pinky finger side) proximal three quarters of medial and anterior surfaces of ulna and IO membrane

182
Q

flexor pollicis longus origin

A

anterior surface of radius and IO membrane

183
Q

flexor digitorum profundus insertion

A

bases of distal phalanges of 2-5th fingers

184
Q

flexor digitorum profundus innervation

A

lateral part: medial nerve
medial part: ulnar nerve
**not what you’d expect

185
Q

flexor digitorum profundus action

A

flexes wrist joint, flexes distal interphalangeal joints of digits 2-5

186
Q

flexor pollicis longus distal attachment

A

base of distal phalanx of thumb

187
Q

flexor pollicis longus innervation

A

anterior interosseous nerve (from median nerve)

188
Q

pronator quadratus origin

A

distal quarter of anterior surface of ulna

189
Q

pronator quadratus insertion

A

distal quarter of anterior surface of radius

190
Q

pronator quadratus innervation

A

anterior interosseous nerve (from median nerve)

191
Q

what muscle is absent in 10-15% of the population?

A

palmaris longus

192
Q

name the synovial sheaths of extensor tendons from thumb to pinky (at the level of the extensor retinaculum)

A
  1. abductor pollicis longus and extensor pollicis brevis
  2. extensor carpi radialis longus and extensor carpi radialis brevis
  3. extensor pollicis longus
  4. extensor digitorum and extensor indicis
  5. extensor digiti minimi
  6. extensor carpi ulnaris
193
Q

what artery is found posterior to the humerus?

A

profunda brachii (AKA deep brachial artery)

194
Q

what arteries branch off the brachial artery at the cubital fossa?

A

ulnar artery medially, radial artery laterally

195
Q

what veins are found just superior to the cubital fossa?

A 
basilic vein (medial)
cephalic vein (lateral)
196
Q

what veins are found in the cubital fossa and which veins do they flow into?

A

medial cubital vein median antebrachial vein which flows into the basilic vein

197
Q

opponens pollicis innervation

A

recurrent branch of median nerve

198
Q

opponens pollicis action

A

to oppose thumb, draws 1st metacarpal medially to center of palm

199
Q

abductor pollicis brevis innervation

A

recurrent branch of median nerve

200
Q

abductor pollicis brevis action

A

abducts thumb

201
Q

flexor pollicis brevis innervation

A

recurrent branch of median nerve

202
Q

flexor pollicis brevis action

A

flexes thumb

203
Q

adductor pollicis innervation

A

deep branch of ulnar nerve

204
Q

adductor pollicis action

A

adducts thumb toward lateral border of plam

205
Q

lateral antebrachial cutaneous nerve

A

branch of MC nerve, innervates the lateral forearm

206
Q

what are the two ligmanets that make up the coracoclavicular ligament?

A

conoid (medial)

trapezoid (lateral)

207
Q

glenoid labrum

A

fibrocartinage located at the inferior portion of the glenohumeral joint

208
Q

name the ligaments that are located w/i the glenohumeral joint

A

superior, meddle, and inferior glenohumeral ligments

209
Q

ligament that lies lateral of the manubrium and inferior to the clavicle, attaching the clavicle to the 1st ribs

A

costoclavicular ligament

210
Q

location and function of the transverse humeral ligament

A

on the head of the humerus, over tendon of biceps

211
Q

function of the rotator cuff

A

to hold the humerus w/i glenohumeral joint

212
Q

what clinical signs may be present if someone tears their rotator cuff?

A

unable to begin abduction of the arm.

213
Q

location of the anular ligament of radius

A

inferior to the capitulum, lies over the radial head

214
Q

location of the radial collateral ligament

A

lateral to the elbow joint on the radial side (collateral ligament)

215
Q

ulnar collateral ligament

A

lateral to the elbow joint on the ulnar side (collateral ligament)

216
Q

radiocarpal joint type

A

condyloid synovial joint

217
Q

radiocarpal joint articulating bones

A

distal end of radius and articular disc w/ prox. row of carpal bones (EXCEPT pisiform)

218
Q

intercarpal joint type

A

plane synovial joint

219
Q

intercarpal joint movements

A

slight gliding, some flexion and abduction

220
Q

carpometacarpal joint of MC1 and trapezium type

A

synovial saddle joint

221
Q

carpometacarpal joints (except MC1 and trapzium) type

A

plane synovial joints

222
Q

metacarpalphylangeal joint types

A

condyloid synovial joints

223
Q

interphalangeal joint types

A

hinge synovial joints

FOCA (7 decks)

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