Module 6: The Upper Limb Flashcards
Function of the pectoral girdle
-connect upper limb to thorax
Joints of the pectoral girdle
-glenohumeral joint
-acromioclavicular joint
-sternoclavicular joint
Ligaments of the pectoral girdle
-acromioclavicular
-coracoacromial
-coracoclavicular
-glenohumeral
Acromioclavicular ligament
-between acromion process and clavicle
-reinforces acromioclavicular joint and supports superior shoulder surface
Coracoacromial ligament
-between acromion and coracoid process of scapula
-forms a “vault” that prevents displacement of humeral head superiorly
Coracoclavicular ligament
-main stabilizer of acromioclavicular joint
-anchors clavicle to coracoid process of scapula
Glenohumeral ligament
-largest
-stabilizes glenohumeral joint during abduction of arm
Anterior shoulder subluxation
-occurs when head of humerus is partially displaced anteriorly out of the glenoid cavity
Anterior shoulder subluxation symptoms
-pain
-limited ROM
-palpable gao
-swelling
-bruising
How does an anterior shoulder subluxation happen
-results as a fall on outstretched arm or sports related injury
Glenohumeral joint
-ball and socket
-between glenoid cavity of scapula and large head of humerus
Glenoid labrum
-rim of fibrocarilage that deepens glenoid cavity
-improves stability of joint
Musculature of glenohumeral joint
-rotator cuff group
-biceps brachii
Rotator cuff group
-subscapularis
-supraspinatus
-infraspinatus
-teres minor
Biceps brachii
-attaches to superior glenoid tubercle of scapula
-helps stabilize
What is a bursa
-fluid filled sac lined by synovial membrane that provide cushion between bones and muscles and prevent friction
What are the 2 upper limb bursae
-subacromial bursa
-subdeltoid bursa
Subacromial bursa
-seperates superior surface of supraspinatus tendon from acromion, the coracoid, and coaco-acromial ligament superiorly
Subdeltoid bursa
-separates deep surface of deltoid muscle from shoulder joint
Shoulder bursitis
-results from inflammation and thickening of bursae due to increased amount of friction
Shoulder bursitis causes
-too much friction on subacromial or subdeltoid bursae
-can result from repetitive motions such as baseball player throwing ball
Shoulder bursitis symptoms
-excessive swelling
-warmth
-pain
Scapulohumeral muscles
-teres major
-supraspinatsus
Function of the scapulohumeral muscles
-connect to the scapula and function to stabilize glenohumeral joint
Teres major
-originates on inferior part of lateral border of scapula and inserts on medial lip of intertubercular sulcus on humerus
-extends and medially rotates
Supraspinatus
-originates on supraspinous fossa of scapula and inserts on greater tubercle of humerus
-adduction
Infraspinatus
-originates in infraspinous fossa of scapula
Subscapularis
-originates in subscapular fossa of scapula
-anterior to other 3 rotator cuff muscles
Teres minor
-originates from middle of lateral border of scapula
Spuraspinatus tear
-involves rupture of tendon near site of insertion
-fairly common
Supraspinatus tear causes
-history of trauma
-increased age
-lifting something heavy
Supraspinatus tear symptoms
-audible pop
-rapid onset of shoulder pain
-swelling at shoulder
-reduced range f motion
Muscles of the anterior compartment of the arm
-biceps brachii
-coracobrachialis
-brachialis
What action is the anterior compartment of the arm responsible for
-flexion
Muscles of the posterior compartment of the arm
Triceps brachii heads
-long head
-lateral head
-medial head
Where does long head of triceps brachii come from
-infraglenoid tubercle of scapula
Where do lateral and medial heads come from
-posterior surface of humerus
Where do all 3 heads of triceps brachii insert onto
-insert at a common tendon, the triceps tendon
-onto the olecranon of the ulna
Cubital fossa location
-anterior surface of elbow joint
-triangular depression
Cubital fossa function
-passage of improtant neurovascular structures
Superior border of cubital fossa
-imaginary line between humeral epicondyles
Lateral border of cubital fossa
-brachioradialis
Medial border of cubital fossa
-pronator teres
Contents of cubital fossa
-brachioradialis
-brachial artery
-biceps brachii tendon
-radial artery
-ulnar artery
-pronator teres
-median nerve
The popeye deformity
-can result due to rupture of muscle at the site of origin and/or insertion
Common muscle involved in popeye deformity
-triceps tendon
Popeye deformity symptoms
-pain
-swelling
-visible bruising
-weakness in elbow flexion
Parts of the elbow joint
-humeroradial joint
-humeoulnar joint
-superior radioulnar
Humeroradial joint
-between capitulum of humerus and concave upper suface head of radius
Humeroulnar joint
-joint between trochlea of humerus and trochlear notch of ulna
Superior radioulnar joint
-synovial joint between head of radius and radial notch of ulna
Lateral epicondylitis
-tennis elbow
-common overuse injury
-tiny tears in extensor carpi radialis
Lateral epicondylitis symptoms
-pain and tenderness at rest and during movement
-limited mobility and reduced strength especially during extension of elbow
Joints and ligaments of forearm
-proximal radioulnar joint
-annular ligament
-interosseous membrane
-distal radial notch
Proximal radioulnar joint
-formed between head of radius and radial notch of ulna
Annular ligament
-encircles head of radius
-holding it against radial notch of ulna
Interosseous membrane
-fibrous joint
-spans space between ulna and radius and divides forearm into anterior and posterior compartments
Distal radioulnar joint
-formed between head of ulna and ulnar notch of radius
Radial head subluxation
-when upper limb is jerked superiorly resulting in partial dislocation of the head of radius from annular ligament
What population is radial head subluxation common in
-children
-because ligaments are not fully formed
Radial head subluxation symptoms
-audible pop
-pain with supination
-limited extension and flexion of forearm
Superficial muscles of anterior compartment of forearm
-pronator teres
Intermediate muscles of anterior compartment of forearm
-flexor digitorum superficialis
Deep muscles of anterior compartment of forearm
-flexor digitorum profundus
-flexor pollicis longus
-pronator quadratus
Pronator teres syndrome
-can be caused by repetitive pronation of forearm
-pronator teres hypertrophy which can entrap median nerve
Pronator teres syndrome symptoms
-pain in anterior forearm
-may be worsened by resisted pronation of forearm and flexion of elbow
-significant weakness flexing wrist
-weakness in movements of thumb and numbness and tingling of hand and first 4 digits
Superficial muscles of posterior compartment of forearm
-extensor digitorum
Extensor digitorum function
-extend digits 2-5, hand, and wrist
Extensor digitorum muscle strain
-overuse injury
Extensor digitorum muscle strain symptoms
-reduced grip strength and stiffness in fingers
The carpal bones
-scaphoid
-lunate
-triquetrium
-pisiform
-trapezium
-trapezoid
-capitate
-hamate
Which carpal bone is most often involved in fractures
-scaphoid bone
Scaphoid bone fracture
-fall on extended wrist
Scaphoid bone fracture symptoms
-pain and tenderness
-bone out of alignment
-pain with adduction of thumb
Joints of wrist and hand
-intercarpal
-midcarpal
-radiocarpal
Intercarpal joint
-between carpal bones
-sliding motion
Midcarpal joint
-between proximal and distal rows of carpal bones
-gliding movement
Radiocarpal joint
-wrist
-radius and proximal carpal bones (not pisiform)
-extension, flexion, ab/adduction, and circumduction
Carpal tunnel
-concavity covered by flexor retinaculum
-on anterior surface of wrist
Function of carpal tunnel
-passage of median nerve, 4 flexor digitorum superficialis tendons, 4 flexor digitorum profundus tendons, and 1 flexor pollicis tendon
Carpal tunnel syndrome
-when median nerve had pressure placed upon it
-often linked to repetitive movements
Carpal tunnel syndrome symptoms
-pain worse with movement
-numbness and tingling of thumb, index, middle and 1/2 of 4th finger on palmar side
Extrinsic muscles of hand
-extensor digitorum
Extensor retinaculum
-ligamentus sheet that extensor muscles pass deep to
Intrinsic muscles of the hand
-hypothenar and thenar
-interosseous
Hypothenar muscles
-responsible for movement of pinky
Thenar muscles
-responsible for movements of thumb
Interosseous muscle types
-dorsal
-palmar
Dorsal interosseous muscles
-responsible for finger abduction
Palmar interosseous muscles
-resposible for finger adduction
Tight palmar interossei
-can become tight due to overuse injury, dehydration, or stress
Tight palmar interossei symptoms
-inability to bear weight
-pain with palpation
Vasculature of hand
-superficial palmar arch
-deep palmar arch
Superficial palmar arch
-ulnar artery forms it and is completed by radial artery
-located superficial to flexor tendons of hand
What does superficial palmar arch supply
-medial 3 and a half fingers
Deep palmar arch
-radial artery curves dorsally to enter and and is compared by deep branch artery
What does the deep palmar arch supply
-thumb and lateral half of 2nd finger
Hypothenar hammer syndrome
-if blood flow is blocked in ulnar artery
Hypothenar hammer syndrome symptoms
-ischemia
-discolouration
-parasthesia
-temp sensitivity of digits 2-5
Nerves involved in sensory innervation of hand
-ulnar nerve
-median nerve
-radial nerve
Ulnar nerve
-sensation to skin of palmar and dorsal aspects of medial 1 and a half digits (4&5)
-adjacent palm
Median nerve
-cutaneous skin of lateral 2/3 of palm
-palmar surfaces of lateral 3 and a half digits
-dorsum of distal halves of same digits
Radial nerve
-cutaneous skin of lateral dorsal aspect of hand
-proximal dorsal aspects of digits 1,2,3
-lateral half of digit 4
