Module 6 - Upper limb Flashcards
1
Q
functions of the pectoral girdle
A
connect upper limb to thorax
2
Q
scapulothoracic joint
A
theoretical joint between scapula and posterior thoracic cage
3
Q
movements of the humerus are accompanied by…
A
movements of the scapula and clavicle
4
Q
Glenohumeral joint
A
glenoid fossa articulated with the humerus
5
Q
acromioclavicular joint
A
acromion articulated with the clavicle
6
Q
sternoclavicular joint
A
sternum articulated with the clavicle
7
Q
Ligaments of the pectoral girdle
A
- acromicoclavicular ligament
-coracoacromial ligament
-coracoclavicular ligament
-glenohumeral ligament
8
Q
acromicoclavicular ligament
A
lovated between the acromion of the scapula and the clavicle, reinforcing ac joint and supports superior surface of the shoulder
9
Q
coracoacromial ligament
A
-connects the acromion and coracoid proccess of scapula
-forms a vault that prevents displacement of the humeral head superiorly
10
Q
coracoclavicular ligament
A
main stabilizer of the ac joint as it anchors he clavicle to the coracoid process of the scapula
11
Q
Glenohumeral ligament
A
-largest ligaments in the pectoral girdle
-stabilize the GH joint, esp during abduction
-not visible superiorly
12
Q
Anterior Shoulder Subluxation
A
- occurs when head of humerus is partially displaced anteriroly out of glenoid cavity
-typically occurs bc FOOSH or sports
13
Q
what sports players ater partial to anterior shoulder subluxation
A
baseball players
14
Q
symptoms of anterior shoulder subluxation
A
- pain in affected shoulder
-limited ROM
-palpable gap bw acromion and humeral head
-swelling/bruising from broken blood vessels
15
Q
GH joint
A
-ball and socket
-poor fit of articualr surfaces alon with loose fibrous capsule permits extensive mobility at the expense of stability
16
Q
Glenoid Labrum
A
- stabilizes the GH joint
-rim of fibrocartilage that deepends the glenoid cavity improving joint stabiltiy
17
Q
msucles of GH joint (rotator cuff)
A
-supraspinatus
-infraspinatus
-teres minor
-subscapularis
18
Q
what is the rotator cuff also known as
A
dynamic ligaments because they make up for lack of supportive ligaments
19
Q
what msucle that is not part of the rotator cuff helps stabilize GH joint
A
biceps brachii
20
Q
bursae of the shoulder
A
- subacromial
-subdeltoid
21
Q
what are bursae
A
fluid-filled (synovial fluid) sacs lined by synovial memrbane that provide cushioning between bones, tendons, and muscles to prevent friction
22
Q
Subacromial bursae
A
- separates superior surface of infraspinatus tendon from acromion, coracoid and coraco-acromial ligament
23
Q
subdeltoid bursae
A
separates deep surface of the deltoid muscle from the shoulder joint
24
Q
both subacromial and subdeltoid bursae protect
A
supraspinatus from friction with overlying structures
25
Shoudler bursitis
-if bursae become inflammed/swollen
-pain that results from thickening/inflammation due to increase amnt of friction
26
causes of shoulder bursitis
too musch friction resulting from repetitive motions
27
symptoms of shoulder bursitis
- excessive swelling in region
-warmth at site of inflammation
-pain with movement/pressure at shoulder
28
Scapulohumeral muscles
- connect humerus to the scapula and function to stabilize the GH joint
29
Teres Major origin
inferior part of the lateral border of scapula
30
teres major insertion
medial lip of the intertubercular sulcus on the humerus
31
teres major action
extension and ,edial rotation of the humerus (arm)
32
Supraspinarus origin
the supraspinous fossa of the superior part of the scapula
33
supraspinatus insertion
greater tubercle of the humerus
34
supraspinatus action
abduction of humerus
35
Supraspinatus location
originates in the supraspinous fossa of the scapula, superior to the scapular spine
36
infraspinatus location
originates in the infraspinatus fossa of the scapula, inferior to the scapular spine and superior to teres minor
37
subscapularis msucle location
originates in the subscapular fossa and is anterior to the three other rotator cuff muscles, while inferior to the coracoid process
38
teres minor location
originates from the middle of the lateral border of the scapula
39
Supraspinatus tear
rupture of the tendon near the site of insertion
**fairly common as it is easily pinched/torn between greater tubercle and acromion
40
causes for supraspinatus tear
-history of trauma and increased age are most common risk factors
-typically occur when lifting something heavy or too quickly
41
symptoms supraspinatus tear
-audible pop
-rapid onset shoulder pain
-swelling
-reduced ROM
42
Anterior muscles of the arm
- biceps brachii
-coracobrachialis
-brachialis
43
flexion of the forearm at the elbow is facilitated by the
biceps brachii and brachialis
44
what flexes the arm at the GH joint
coracobrachialis
45
which muscle is a powerful supinator of the arm
biceps bracii
46
Muscles of the posterior compartment of the arm
triceps brachii (3 heads)
47
heads of the triceps brachii
1. Long health from infraglenoid tubercle of scapula
2 medial health from posterior humerus
3. Lateral head from posterior humerus
48
where do the triceps bracii insert
a common tendon, the triceps tendon, at the olecranon of the ulna
49
what action do the triceps brachii do
extension
50
what is the cubital fossa
triangular depression on the anterior elbow joint containing neurovascular structures
51
Superior border of the cubital fossa
imaginary line between the humeral epicondyles
52
Lateral border of the cubital fossa
Brachioradialis
53
medial border of the cubital fossa
pronator teres
54
what does the cubital fossa contain
tendon of biceps brachii and brachial artery and median nerve
55
what does the brachial artery bifurcate into
the ulnar and radial artery
56
Where does the brachiala rtery bifurcate
the cubital fossa
57
Popeye deformity
- bulge in upper arm
-result due to rupture of biceps brachii
-recoiled shortened muscle
symptoms include: pain, bruising, weakness in elbow flexion
58
three articulations of the elbow joint
1. Humeroradial joint
2. Humeroulnar joint
3. Superior (proximal) radioulnar joint
59
Humeroradial joint
joint between the capitulum of the humerus and the head of radius
60
Humeroulnar joint
joint between trochlea of the huerus and the trochlear notch of ulna
61
Superior radioulnar joint
synovial joint between head of radius and radial notch of the ulna
62
Lateral Epicondylitis
- aka tennis elbow
-overuse injury
-related to extensor msucles
-tiny tears occur at tendinous origin of extensor muscles at the lateral epicondyle
-most common muscle tendon implicated is extensor carpi radialis brevis
63
symptoms of lateral epicondylitis
-pain/tender at lateral elbow (at rest and/or during mvmnt)
-limited mobility
-reduced strength (esp during extension)
64
Annular ligament
encircles the head of the radius, holding it against the radial notch of the ulna (proximal radioulnar joint)
65
Interosseous membrane
fibrous joint that spans the space between the ulna and radius and divides the forearm into anterior and posterior compartments
66
distal radioulnar joint
formed between the head of the ulna and the ulnar notch of the radius
67
Radial Head Subluxation
-commonly seen in young children
-partial dislocation of radioulnar joint
-occurs when upper limb jerked superiorly and pronated resulting in partial dislocation head of radius from annular ligament
68
symptoms of radial head subluxation
-audible pop
-pain with supination and pronation
-limited extension and flexion of forearm at elbow joint
69
Superficial anterior muscles of the forearm
pronator teres
70
intermediate anterior muscles of the forearm
-flexor digitorum superfiscialis
71
deep anterior msucles of the forearm
-flexor digitorum profundus
-flexor pollicus longus
-pronator quadratus
72
Pronator Teres Syndrome
-repetitive pronation may have caused pronator teres hypertrophy
-this entraps median nerve
73
pronation is facilitated by
the pronator teres
74
Symtoms of pronator teres syndrome
- pain in anterior forearm aggrivate dby resisted pronation and elbow flexion
-weakness when flexing wrist
-[weakness in movements of thumb and numbness/tingling
75
what does the median nerve supply
motor innervation to the anterior compartment of the forearm and motor and sensory innervation to the hand
76
layers of the posterior compartment of the forearm
superficial and deep
77
extensor digitorum
-in superior layer
- ficntions to extend digits and hand at the wrist
78
Extensor digitorum msucle strain
-from overuse
-reduced grip strength & stiffness in fingers
-activities cause include knitting, hammer/screwdriver and piano
79
how to distnguish between pronator teres syndrome and extensor digitorum strain
- pronator teres responsible for pronation
-extensor digitorum responsible for extension
-pronator teres syndrome also inclues muscles and NERVE
80
proximal row of carpal bones
-scaphoid
-lunate
-triquetrium
-pisiform
81
distal row of carpal bones
-trapezium
-trapedoiz
-capitate
-hamate
82
what carpal bone is more prone to fractures from FOOSH
scaphoid; bc it is largest bone articulating with the radius
83
Fracture of scaphoid bone
-from FOOSH commonly
-pain an dtenderness over the bone
-may also be displaced
-may result in great pain with abduction and adduction of the thumb
84
Joints of the wrist
1. Intercarpal
2. Midcarpal
3. Radiocarpal
85
Intercarpal joints
synovial plane joints between the carpal bones, capable of slight gliding movements
86
Midcarpal Joints
articulation between the proximal and distal rows of carpal bones, capable of slight gliding movements
87
Radiocarpal joint
-wrist joint
-biaxial, synovial, ellipsoidal joint between radius and proximal row of carpal bones (not pisiform)
-function in extension, abduction, aduction and circumduction
88
the carpal tunnel
-carpal bones form a concavity covered by the flexor retinaculum
-allows passage of median nerve and nine flexor tendons
89
what flexor tendons pass through the carpal tunnel
4 flexor digitorum superfiscialis, 4 flexor digitorum profundus, ad flexor pollicis longus
90
Carpal Tunnel Syndrome
-occurs when it becomes narrowed or when structures surrounding median nerve put pressure on the median nerve
-often linked to repetitive movements of wrist during flexion and extension
91
carpal tunnel syndrome
-pain in the anterior wrist and ahnd that is worse with wrist movemtn
-numbness and tingling of the thumb, index and middle and 1/2 of 4th finger on palmar side
-follows path of sensory innervation supplied by the median nerve
92
how does pronator teres syndrome compare to carapl tunnel syndrome
site of impingement differs (medial for pronator and distal for carpal)
93
extrinsic muscles of the hand
flexor and extensor muscles of the forearm and insert into the hand
94
the extensor muscle tendons pass deep to the
extensor retinaculum
95
extensor retinaculum
a broad ligamentous sheet located at the dorsal aspect of the wrist to hold tendons in place
96
intrinsic muscles of the hand
originate and insert within the hand and are responsible for fine skilled movements
97
Hypothenar muscles of the hand
responsible for the movement of the 5th digit
98
thenar muscles of the hand
responsible for movements of the thumb
99
dorsal interossei
responsible for finger abduction
100
palmar interossei
responsible for finger adduction
101
Tight Palmar Interossei
-palmar interossei muscles can become tight due to overuse, injury, dehydration or stress
-potential to result of spasam
102
radial and ulnar arteries continue down the hand to form
two arterial arches:
1. Superficial Palmar Arch
2. Deep Palmar Arch
103
Superficial Palmar Arch
-ulnar artery passes superficial to flexor retinaculum to form superficial palmar arch
-medially, arch is completed by radial artery
-located superficial to the long flexor tendons of the hand
104
superficial palmar arch supplies
4 branches to supply the medial three and a half fingers
105
Deep Palmar Arch
-radial artery curves dorsally to enter deep palm
-completed by the deep branch of the ulnar artery
106
what does the deep palmar arch supply
gives off branches which supply the thumb, and lateral half of 2nd finger
107
Hypothenar Hammer Syndrome
-due to superficial nature of ulnar artery in the palmar region, trauma to palmar portion may occur to hypothenar region such as hammering
-ulnar artery gets compressed against adjacent boney hook of hamate
108
what would someone with hypothenar hammer syndrome experience
ischemia (loss of BF) to medial part of hand, discolouration, paresthesia (pins and needles) and temperature sensitivity
109
terminal nerves of the brachial plexus that provide cutaneous innervation to the hand
1. Ulnar nerve
2. Median Nerve
3. Radial Nerve
110
Ulnar Nerve
-cutaneous branches provide sensory innervation to the skin of the palmar and dorsal aspects of the medial 1 1/2 digits and adjacent palm
111
Median Nerve
-supplies cutaneous innervation to the skin of the lateral two thirds of the palm, the palmar surfaces of the lateral three and a half digits and the dorsum of distal halves of same digits
112
Radial Nerve
- superficial branch passes from anterolateral aspect of the forearm to dorsum of hand
-provides cutaneous innervation to the skin of the lateral half os dorsal aspect, proximal portions of dorsal aspect of digits 1,2,3 & lateral half of digit 4
