Morphological plan of the upper limb

Question 1

Anatomical evolution

Answer 1

Changes to the foot, hip, knee, vertebral column, skull

Longer clavicles

Pronation/ supination

Opposable thumb

Question 2

Basics of upper limb

Answer 2

32 bones

57 muscles

Brachial plexus

Major vessels

Question 3

Arrangement of upper limb

Answer 3

Shoulder

Arm

Elbow

Forearm

Wrist

Hand

(course muscle to fine muscle)

Question 4

Skeleton

Answer 4

Pectoral girdle (scapula and clavicle)

Humerus

Radius

Ulna

Carpal bones (8)

Metacarpals (5)

Phalanges (14)

Question 5

Scapula and humerus

Answer 5

Acromium

Coracoid

Spine

Superior angle

Inferior angle

Lesser trochanter

Greater trochanter

Intertubercular sulcus

Lateral epicondyle

Medial epicondyle

Deltoid tuberosity

Question 6

Radius and ulna

Answer 6

Olecranon

Ulna tuberosity

Styloid process of ulna

Head

Radial tuberosity

Styloid process of radius

Interosseous membrane §

Question 7

Limb movements

Answer 7

Flexion/ extension

Abduction/ adduction

Lateral/ medial rotation

Pronation/ spination

Circumduction

Opposition

Question 8

Joints of the upper limb

Answer 8

Glenohumeral

Elbow

Wrist (radiocarpal)

Midcarpal

Carpometacarpal

Metacarpophalangeal

Interphalangeal

Question 9

Attachment of the upper limb to the trunk

Answer 9

From vertebral column
- superficial back muscles

From thoracic wall

• pectoralis major/ minor
• serratus anterior

Question 10

Muscles of shoulder joint

Answer 10

Deltoid

Rotator cuff muscles

Teres major

Question 11

Flexor muscles of the arm

Answer 11

Coracobrachialis

Biceps brachii

Brachialis

Question 12

Extensor muscles of the arm

Answer 12

Tricpes brachii

Question 13

Forearm muscles

Answer 13

Flexors of wrist and digits

Extensors of wrist and digits

Question 14

Hand muscles

Answer 14

Thenar muscles

Hypothenar muscles

Question 15

Movements of the vertebral column

Answer 15

Flexion/ extension

Lateral flexion/ lateral extension

Rotation

Question 16

Curvatures of the vertebral column

Answer 16

Cervical

Thoracic

Lumbar

Sacral

Question 17

Function of curvatures

Answer 17

Bipedalism

Shock absorption

Flexibility

Question 18

Ligaments

Answer 18

Reinforce and stabilise joints

Limit range of movement

Question 19

Spinal ligaments resisting hyperextension

Answer 19

Anterior longitudinal ligament

Question 20

Spinal ligaments resisting hyperflexion

Answer 20

Posterior longitudinal ligament

Ligamentum flava

Question 21

Intervertebral joints and discs

Answer 21

Joints for weight bearing and strength

Secondary cartilaginous

Discs: shock absorbers

Disc thickness increases down the vertebral column

Question 22

Facet joints

Answer 22

Joints between vertebral arches

Synovial

Movement depends on joint angle

Question 23

Cervical facet joint

Answer 23

Slight slope

Flexion/ extension/ rotation

Question 24

Thoracic facet joint

Answer 24

Near vertical

Rotation only

Question 25

Lumbar facet joint

Answer 25

Wrapped

Flexion/ extension only

Question 26

Muscles of the back

Answer 26

Extrinsic muscles (move upper limbs and ribs)
- superficial and intermediate

Intrinsic muscles (postural/ move vertebral column)
- deep

Separated by thoracolumbar fascia

Question 27

Superficial muscles

Answer 27

Attach upper limb to trunk

• trapezius
• latissimus dorsi
• levator scapulae
• rhomboids (minor and major)

Question 28

Function of trapezius

Answer 28

Rotates scapula

Question 29

Function of latissimus dorsi

Answer 29

Adducts/ extends/ medially rotates arm

Question 30

Function of levator scapulae

Answer 30

Elevates scapula

Question 31

Function of rhomboids

Answer 31

Retracts scapula

Question 32

3 layers of deep muscles

Answer 32

Splenius- most superficial (in neck)

Erector spinae- main group

Mulitfidus- very deep

Question 33

Erector spinae

Answer 33

3 muscle blocks

Within groove between spinous process and angles of the ribs

Question 34

3 muscle blocks of erector spinae

Answer 34

Spinales: to spinous processes

Longissimus: to transverse processes

Iliocostalis: to ribs

Origin: errector spinae aponeurosis

Question 35

Nerve supply

Answer 35

Anterior primary ramus
- extrinsic muscles

Posterior primary ramus
- intrinsic muscles

Question 36

Primary curvatures

Answer 36

Kyphoses

Develop fetally

Thoracic and sacral

Question 37

Secondary curvatures

Answer 37

Lordoses

During childhood

Crawling to walking

Cervical and lumbar