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Anatomy > MSK upper limb 1 > Flashcards

MSK upper limb 1 Flashcards

1
Q

Complete the diagram

A
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2
Q

Which ligament holds the ulnar in place?

Which ligament holds the head of the radius in place?

A

Ulnar collateral ligament

Annular ligament

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3
Q

Which muscles cause flexion of the elbow joint

A

Biceps brachii, brachioradialis and brachialis

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4
Q

Label this diagram

A
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5
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Label

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6
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Label

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7
Q

Label

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8
Q

Muscles involved insupination of the elbow

A
  1. Supinator
  2. Biceps brachii
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9
Q

Muscles invovled in pronation of the elbow

A

Pronator teres

Pronator quadratus

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10
Q

Label diagram

A
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11
Q

Label

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12
Q

Label

Insersion for pec minor

A

Coracoid process (Also biceps short head & coracobrachialis)

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13
Q

Label

Name branches of brachial plexus & what cords they come from

A

Ulnar- Medial

Median- lateral & medial

Radial- posterior

Musculocutaneous- lateral

Axillary- posterior

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14
Q

Insersion and origin for biceps brachi, two heads and deltoid

A

Biceps brachi

Long head: supraglenoid tubercle of scapula

Short head: coracoid process

Insersion: Tuberosity of radius

Deltoid

Insertion: Clavicle, acromion & spine of scapula

Origin: Deltoid tuberosity on the humerus

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15
Q

What is the Common flexor origin & what muscles originate here

A

Medial epicondyle of the humerus

  • Pronator teres
  • Flexor carpi ulnaris
  • Flexor digitorum superficialis
  • Flexor carpi radialis
  • Palmaris longus
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16
Q

What is the Common extensor origin & what muscles originate here

A

Lateral epicondyle of the humerus

  • Extensor digitorum
  • Extensor digiti-minimi
  • Extensor carpi ulnaris
  • Extensor radialis brevis
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17
Q

Biceps brachii insertion & origin

A

Origin: Long head:

LH: supraglenoid tubercle of scapula

SH: coracoid process

Insersion: tendon, into the radial tuberosity

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18
Q

Brachioradialis insertion & origin

A

Humerus

inserts into Radial styloid process

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19
Q

What attaches onto green & blue parts

A

Pec minor- green (the inserts onto coracoid process)

Serratus anterior- blue

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20
Q

Green & blue attachments

A

Pec major

Origin= Clavicular & sternocostal heads

Insertion= intertubercular groove

Teres major

Origin= Inferior angle & lateral border of the scapula

Insertion= intertubercular groove

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21
Q

Coracobrachilis insertion & origin

A

Origin= coracoid process

Insertion= mid shaft of humerus

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22
Q

Deltoid attachments

A

Origin= Clavicle, acromion & spine of scapula

Insertion= Deltoid tuberosity

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23
Q

What attaches onto the infra-glenoid tubercle of the scpula

A

Attachment of triceps brachii: long head

Insertion- Olecranon process of the ulna

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24
Q

Label

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25
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Label

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26
Q

Label

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27
Q

Label the image

A
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28
Q

Complete diagram

A
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29
Q

Label

A
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30
Q

What does the radial nerve innervate & what are its nerve roots

A

Sensory – Innervates most of the skin of the posterior forearm, the lateral aspect of the dorsum of the hand, and the dorsal surface of the lateral three and a half digits.

Motor – Innervates the triceps brachii and the extensor muscles in the forearm.

nerve roots C5-T1

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31
Q

Complete diagram

A

Note that the axillary artery turns into the brachial artery at the lower border of the pec major

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32
Q

Label the contents of the axilla

A
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33
Q

At what anatomical point does the axillary artery begin and end and from which artery?

A

lateral margin of the first rib and then lower border of teres major

subclavian artery

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34
Q

Roots & cords of the brachial plexus

A

Ulnar- C8 & T1 Medial branch

Median- C6, 7, 8, T1 Lateral & medial branch

Radial- C5-T1 Posterior branch

Musculocutaneous- C5, 6 & 7 Lateral branch

Axillary- C5 & 6 Posterior branch

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35
Q

What is Erb’s palsy

A

Erb’s palsy refers to an injury to the upper roots of the brachial plexus (typically C5-6). It most commonly occurs as a result of a stretching injury during a difficult vaginal delivery.

Nerves affected – the peripheral nerves derived from C5-6 roots are most affected. This includes the musculocutaneous, axillary, suprascapular, and nerve to subclavius.

Muscles affected – supraspinatus, infraspinatus, subclavius, biceps brachii, brachialis, coracobrachialis, deltoid and teres minor.

Motor functions affected – abduction at shoulder, lateral rotation of arm, supination of forearm, and flexion at shoulder.

Sensory functions affected – sensation over the lateral aspect of upper limb (C5-6 dermatomes).

The affected limb hangs limply, medially rotated by the unopposed action of pectoralis major. The forearm is pronated due to the loss of biceps brachii. The wrist is weakly flexed due to the normal tone of the wrist flexors relative to the weakened wrist extensors. This is position is known as ‘waiter’s tip’ and is characteristic of Erb’s palsy

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36
Q

What is Klumpke’s Palsy

A

Claw hand= Ulnar nerve

Injury of the lower roots of the brachial plexus (C8-T1).

Nerves affected – the peripheral nerves derived from T1 root are most affected; the ulnar and median nerves

Muscles affected – the intrinsic hand muscles

Sensory functions affected – sensation along medial side of upper limb (C8-T1 dermatomes).

The primary feature of Klumpke’s palsy is a clawed hand. This occurs due to paralysis of the lumbrical muscles, which normally act to flex the metacarpophalangeal joints (MCPJs) and extend the interphalangeal joints (IPJs). When paralysed, the fingers subsequently become extended at the MCPJs and flexed at the IPJs, producing a clawed appearance.

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37
Q

Label

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38
Q

Label

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39
Q

Where does lymph from the medial & lateral part of the breast drain?

A
  1. Medial part of the breast (close to sternum): internal mammary nodes
  2. Lateral part of breast (close to axilla): axillary lymph nodes

The main lymph drainage of the breast is to axillary nodes and to the parasternal nodes along the internal thoracic artery inside the thoracic cavity. The lymphatics of the breast originate in the lymph capillaries of the mammary connective tissue, which surrounds the mammary structures, and drain through the deep substance of the breast.

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40
Q

Orientating the clavicle:

The lateral aspect of a clavicle is x than the medial aspect
The superior surface is x than the inferior surface
The conoid tubercle is on the x aspect of the x portion of the clavicle

A

The lateral aspect of a clavicle is flatter than the medial aspect

The superior surface is smoother than the inferior surface

The conoid tubercle – attachment for the conoid ligament – is on the inferior aspect of the lateral portion of the clavicle

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41
Q

How is the underside of the clavicle fixed to the coracoid process

A

Trapezoid ligament in front and conoid ligament behind

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42
Q

label

A
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43
Q

Label

A
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44
Q

What type of synovial joint are the acromioclavicular (AC) and sternoclavicular (SC) joints?

A

AC joint: Synovial Plane joint

SC joint: Saddle shaped synovial joint

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45
Q

What attachement is this showing

A

Long head of biceps brachi to the supraglenoid tubercle

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46
Q

Label

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47
Q

Label

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48
Q

Where does the axillary nerve lie on the humerus

A

directly posterior, along humeral neck

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49
Q

Label the two parts of the scapula

A
50
Q

Label

A
51
Q

Where does the triceps insert

A

Olecranon process of ulna

52
Q

Name therim of cartilage surrounding the socket of the shoulder joint

A

Glenoid labrum

53
Q

Label

A
54
Q

Label

A
55
Q

Function of Coracoacromial ligament

A

prevents superior displacement of the humeral head.

56
Q

Which part of the shoulder joint capsule is weakest, as it is not protected by muscles or ligaments?

A

Inferior aspect

57
Q

Name the two main bursae of the shoulder joint

A

Subacromial and subscapular bursae

58
Q

Label two main bursae of shoulder

A

a) subacromial bursae
b) subscapular bursae

59
Q

Which bursa communicates with the joint cavity?

A

The subscapular bursae communicates with the glenohumeral joint between the superior & middle glenohumeral ligaments

60
Q

What is the role of subacromial bursa?

A

The subacromial bursa protects the underlying supraspinatus muscle from attrition wear between the humeral head and the acromion

61
Q

What common sporting injury damages the subacromial bursa?

A
  • Rotator cuff pinching and tendinitis; often in sports requiring arms to be moved over the head repeatedly e.g. baseball pitching, serving in tennis, swimming
62
Q

Name the 4 rotator cuff muscles & identify their main action

A

· S – Supraspinatus – abducts the arm

· I – Infraspinatus – externally rotates the arm

· T – Teres minor – externally rotates the arm

· S – Subscapularis – internally rotates the arm

63
Q

DIstal attachement for the 4 rotator cuff muscles

A

Subscapularis- lesser tubercle

infraspinatus, teres minor & supraspinatous= greater tubercle

64
Q

Function of the anterior, posterior and middle deltoid fibers

what is its nerve supply

A

Anterior fibres of deltoid flexion and medial rotation at the shoulder joint

Middle fibres abduction of the arm at the shoulder joint

Posterior fibres Extension and lateral rotation at the shoulder joint

nerve supply = axilliary nerve

65
Q

what nerve causes winging of the scapula

A

Damage to the long thoracic nerve

66
Q

Distil attachment & action of the pectoralis major muscle

A

The distal attachment of this muscle is to the lateral lip of the intertuburcular groove of the humerus

Its action on the shoulder joint is to adduct the shoulder and internally rotate the humerus at the glenohumeral joint.

Muscle used to throw a ball/in arm wrestle

67
Q

complete

A
  1. Trapezius
  2. Latissimus dorsi
  3. teres major
  4. Deltoid
68
Q

Action of the superior, middle and inferior trapezius fibers

Innervation?

A

Superior fibres of trapezius elevation & rotation during abduction of the scapula

Middle fibres of trapezius adduction/retraction of the scapula (move it back on the thorax)

Inferior fibres of trapezius depress the scapula

Innervation = spinala accessory nerve

69
Q

What muscles flex the shoulder

A
  1. Anterior deltoid muscle
  2. Pectoralis major (upper)
  3. Coracobrachials
  4. Biceps brachii

All at the front; pull the shoulder fowards

70
Q

`what muscles extend the shoulder

A
  1. Deltoid (posterior fibers)
  2. Latissimus dorsi
  3. Teres major

All at the back; pull the shoulder back

71
Q

What muscles adduct the shoulder

A

1. Pectoralis major

2. Latissimus dorsi

3. Teres major

4. Teres minor

- all pull inwards; imagine them forming a triangular pulley

72
Q

What muscles abduct the shoulder from 0-90 degrees

A

Supraspinatous & deltoid (middle fibers)

73
Q

What muscles abduct the shoulder from 90-180 degrees

A

Trapezius & serratus anterior

74
Q

What muscles internally rotate the shoulder

A
  1. Subscapularis
  2. Latissimus dorsi
  3. Pectoralis major
  4. Teres major
  5. Deltoid (anterior)
75
Q

What muscles externally rotate the shoulder

A
  1. infraspinatus
  2. teres minor
76
Q

Action of biceps brachii and location of insertion

A

Action- flexion of elbow & shoulder

supination of elbow

77
Q

Where does the brachial artery bifurcate into the radial and ulnar artery?

A

cubital fossa at the level of the radial neck, below the bicipital aponeurosis

78
Q

Label this

A
79
Q

Complete the diagram

A
80
Q

Complete the diagram

A
81
Q

Complete

A
82
Q

What artery forms the deep vs superficial palmar arch

A

Deep= radial artery

Superficial = ulnar artery

83
Q

Complete

A
84
Q

Fill in the diagram

A
85
Q

Complete

A
86
Q

Complete

A
87
Q

Describe consequence of an injury to the axillary nerve & the usual location of injury to this nerve

A

Humeral neck fracture/dislocation

Erb’s palsy- waiters tip: hyperextension injury to the shoulder

Injury to upper trunk: They are supplied by the nerve roots C5 –C6 …Deltoid, bicepps brachi and brachialis, infraspinatus, supraspinatus and serratus anterior muscles…

As a result of injuries to the superior parts of the bra- chial plexus (Erb-Duchenne palsy), paralysis of the muscles of the shoulder and arm supplied by the C5 and C6 spinal nerves occurs: deltoid, biceps, and brachialis. The usual clinical appearance is an upper limb with an adducted shoul- der, medially rotated arm, and extended elbow. The lateral aspect of the forearm also experiences some loss of sensation.

88
Q

What nerve roots make up the brachial plexus

Which roots form the upper, middle and lower trunks

A

Ventral rami of C5-T1

Upper trunk: C5&6

Middle trunk: C7

Lower trunk: C8&T1

89
Q

Describe consequence to an injury to lower trunk

ulnar nerve

what locaiton is the injury

A

Claw hand/Klumpke’s Palsy

  • Ulnar nerve

medial epicondyl fracture

Both injuries are most commonly caused by shoulder dystocia at birth or following traumatic injury (e.g. motor vehicle accident)

90
Q

Describe consequence of injury to radial nerve & how this can occur

A

Wrist drop

Humeral midshaft facture

91
Q

Describe consequence of injury to median nerve & how this can occur

A

Wrist lesion- carpal tunnel syndrom

Hand of benediction

92
Q

Describe consequence of injury to long thoracic n and how this can occur

A

Often during sport, blow to ribs + masectomy

  • winging of scapula
93
Q

Note that the entire upper limb and pectoral girdle articulate at one small joint only - which is this?

A

Sternoclavicular joint

94
Q

Describe the base, apex, walls of the axilla

A

Base:

Apex: lateral border of the first rib, superior border of scapula, and the posterior border of the clavicle.

Lateral border: intertubercular groove of the humerus.

Medial border: Seratus anterior & thoracic wall (ribs & intercostal muscles)

Anterior wall: Pec major, pec minor & underlying subclavius muscle

Posterior wall: Subscapularis, teres major & lattismus dorsi

95
Q

Describe the contents of the axilla

A

Axillary artery, axillary vein, brachial plexus, axillary lymph nodes, biceps brachi (short head) & coracobrachialis tendon

96
Q

Label the extensor expansion diagram

A
97
Q

What is the function of the lumbricals

A

FLexion of the metacarpalphalangeal joint & extension of the interphalangeal joint

  • flex a straightened finger
98
Q

What type of fracture can cause a radial nerve injury

A

Fracture to the spiral groove of the humerus

99
Q

Which vein lies anterior to the roof of the antecubital fossa?

A

Median cubital vein

100
Q

Describe “students elbow”

A

Olecranon bursitis

The subcutaneous olecranon bursa is one of these structures and can be damaged through repeated excessive pressure and friction

101
Q

Tennis elbow

A

Repetitive overuse of the muscles in the forearm causes inflammation of the muscle tendons attached to the lateral epicondyle of the elbow – this is lateral epicondylitis.

102
Q

Golfers elbow- what is it

A

Repetitive overuse of the muscles in the forearm causes inflammation of the muscle tendons attached to the medial epicondyle of the elbow – this is medial epicondylitis.

103
Q

What type of joint is the elbow & the proximal and ditsil radioulnar joint?

A

Elbow= synovial hinge

Proximal & distil tibiofibular= pivot type synovial joints

104
Q

What type of joint is the

sternoclavicular

acromioclavicular

glenohumeral

elbow

radioulnar

wrist (radiocarpal)

carpometacarpal

thumb

metacarpopharyngeal

proximal & distil interphalangeal

A

Sternoclavicular – Saddle

Acromioclavicular – Plane

Glenohumeral – Ball and socket

Elbow – Hinge

Proximal and Distal Radio-ulnar – Pivot

Wrist (Radiocarpal) – Condyloid

Carpometacarpal – Plane except CMC joint of thumb is saddle

Metacarpophalangeal – Condyloid

Proximal and Distal interphalangeal – Hinge

105
Q

Hip –

Knee –

Proximal tibiofibular –

Distal tibiofibular –

Ankle –

Subtalar (Talocalcaneal) -

– Talonavicular

A

Hip – Ball and socket

Knee – Hinge

Proximal tibiofibular – Plane

Distal tibiofibular – Fibrous: syndesmosis

Ankle – Hinge

Subtalar (Talocalcaneal) – Plane (gliding motion)

Talonavicular – Ball and socket (pivot from side to side)

106
Q

What type of joint is the wrist

A

Condyloid joint

107
Q

What type of joint are the carpometacarpal joints

A

plane, except from the thumb which is a saddle

108
Q

What type of joint is the metacarpalpharyngeal

A

Condyloid

109
Q

What type of joint is the proximal and distal interphalangeal

A

Synovial hinge

110
Q
A
111
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A
112
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113
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A
114
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A
115
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A
116
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A
117
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118
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119
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120
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A

Anatomy (30 decks)

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