MSK Anatomy 1 --> Upper Limb Flashcards
Sternoclavicular Type of Joint
Synovial joint
Sternoclavicular Stabilised by
Costoclavicular ligament
Acromioclavicular Type of Joint
Synovial joint
Acromioclavicular Stabilised by
Coracoclavicular ligament
Serratus Anterior Actions
Damage causes winging of scapula
Serratus Anterior Nerve Supply
Long thoracic nerve
Trapezius Actions
Elevates, retracts and rotates scapula
Trapezius Nerve Supply
Accessory nerve
Levator scapulae Actions Elevates scapula
Elevates scapula
Levator scapulae Nerve Supply
Cervical nerve (C3, C4) and dorsal scapular nerve (C5)
Rhomboid major and minor Actions
Retract scapula
Rhomboid major and minor Nerve Supply
Dorsal Scapular nerve
Pectoralis minor Actions
Flexes, adducts, internally rotates shoulder
Pectoralis minor Nerve Supply
Medial pectoral nerve (C8, T1)
Why do fractures occur in clavicle
• The Strong ligaments at either end of the clavicle means that fractures are more common than dislocations’ not a posterior dislocation of the medial end is dangerous as it may compress the great vessels.
Glenohumural joint → Type of Joint
Synovial Joint
Glenohumural joint → Stabilised by
Rotator cuffs
Glenohumural joint → What prevents upward displacement of the humoral head
Coracoacromial ligament
Glenohumural joint → What occupies the space between the greater tubercle of the humerus and the acromian
Rotator cuffs?
Deltoid Action
Shoulder abduction, flexion and extension
Deltoid Nerve supply
Axillary nerve
Pectoralis major Action
Adducts and medially rotates the humerus
Pectoralis major Nerve supply
Lateral and medial pectoral nerve
Latissimus dorsi Action
Adducts, extend and internally rotate the arm
Latissimus dorsi Nerve supply
Thoracodorsal nerve
Teres Major Action
Internal rotation of the humerus
Teres Major Nerve supply
Lower subscapular nerve
Subscapularis Action
Abducts the arm
Subscapularis Innervation
Upper and Low subscapular nerve (C5-C6)
Supraspinatus Action
Internally rotates the humerus
Supraspinatus Innervation
Suprascapular nerve (C5)
Infraspinatus Action
Externally rotates the arm
Infraspinatus Innervation
Suprascapular nerve (C5-C6)
Teres minor Action
Externally rotates the arm
Teres minor Innervation
Axillary nerve (C5)
What are at risk of impingement under coracoacromial arch
The supraspinatus tendon and subacromial bursa
Elbow Joint → Type of Joint
Synovial
Elbow Joint → Stabilised by
Bony morphology, collateral ligaments
Carrying Angle →
The Trochlea projects more distally than the capitulum, creating the ‘carrying angle’ at the elbow joint.
→ Male vs. Females
Muscles of the arm
Triceps
Biceps
Brachialis
Muscles acting on Shoulder joint:
Deltoid
Pectoralis major
Latissimus dorsi
Teres Major
Rotator Cuff Muscles:
Subscapularis
Supraspinatus
Infraspinatus
Teres minor
Triceps action
Extends the forearm
Triceps innervation
Radial and axillary nerve
Biceps action
Flexes elbows supination
Biceps innervation
Musculocutaneous nerve
Brachialis action
Flexion of elbow
Brachialis innervation
Musculocutaneous nerve
Radioulnar Joint → Type of Joint
Synovial Joints
Radioulnar Joint → Actions at Joint
Pronation/Supination
Pronator quadratus
action and nerve supply
Pronates forearm
Median nerve
Pronator teres
action and nerve supply
Pronates Forearm
Median nerve
Supinator
action and nerve supply
Supinates Radial Nerve
Nursemaid’s elbow
Radial head subclavian (pulled elbow or Nursemaid’s elbow) is common in children under 5y; normally caused by a sudden pull on upper limb; radial head pulls out of annular ligament
ulnar nerve damage due to
3Older patients may suffer ulnar nerve damage due to degenerative changes in the cubital tunnel where the ulnar nerve passes behind the medial epicondyle.
Anatomical Snuffbox Boundaries
Posterior → Extensor pollicus longus
Anterior -> Extensor pollicus brevis
Anatomical Snuffbox Contents
Radial Artery
Radial Nerve
Cephalic vein
Single Palmar skin crease common in
DOWNS SYNDROME
Dupuytren’s Contracture →
is a fixed flexion contracture of the hand due to a palmar fibromatosis, where the fingers bend towards the palm. Involves the palmar fascia.
Arterial Supply to the wrist
Radial
Ulnar
Arterial supply to the hand
Superficial palmar arterial arch
Deep palmar arterial arch
Venous Drainage
Dorsal venous plexus of hand?
Motor Nerve to wrist and hand
Radial and Median nerves?
Cutaneous nerve to risk and hand
Radial nerve → thumb to middle ring finger
Ulnar nerve → medial side of ring finger and little finger
- Osteoarthritis in the hand primarily initially affects the
distal interphalangeal (DIP) joints
- Rhuematoid Arthritis (RA) tends to affect
the wrist, MCP and proximal interphalangeal (PIP) joints; RA may cause rupture of flexor and extensor tendons, and deformitis such as Swan Neck and Boutonniere
- Mallet finger results from
forced hyperfexion of the finger which avulses the long extensor tendon, and stop the patient being able to extend the distal interphalangeal joint (DIPJ).