MSK Upper Limb Flashcards
Which 2 muscles make up the anterior wall of the axilla?
Pectoralis major and minor
Which 3 muscles make up the posterior wall of the axilla?
Subscapularis, theres major and latissimus dorsi
What structures form the medial wall of the axilla?
Thoracic wall and serrates anterior
Name the structure that forms the lateral wall of the axilla
Intertubercular sulcus of humerus
The axillary artery is the continuation of which artery?
Subclavian artery
At what anatomical point does the axillary artery begin?
Lateral border of the first rib
The axillary artery continues beyond the axilla as which vessel?
Brachial artery
At what anatomical point does the axillary artery become the brachial artery?
Posterior border of teres major
What forms the brachial plexus?
The VENTRAL rami of C5-T1
Which nerve roots form the upper trunk of the brachial plexus?
C5 & 6
Which root of the brachial plexus form the middle trunk?
C7
Which roots of the brachial plexus form the lower trunk?
C8 & T1
Describe the different parts that the brachial plexus is split into
Roots, Trunks, Divisions, cords, terminal branches
Which artery are the trunk divisions of the brachial plexus named in relation to?
axillary artery in the axilla.
An injury to which trunk of the brachial plexus results in Erb’s palsy?
Upper
An injury to which trunk of the brachial plexus results in Klumpke’s palsy?
Lower
Which side of the arm are the cephalic and basilic veins?
Cephalic is thumb side (thumb and index finger can make a C for Cephalic). Basilic is pinky side
Blood shunts between which vessels in the cubital fossa
From cephalic to basilic
Which vein arises from the lateral end of the dorsal venous arch?
Cephalic
Which vein arises from the medial end of the dorsal venous arch?
basilic
What is the name of the vein which shunts blood between the cephalic and basilic veins?
Median cubital vein
Which dermatome supplies both sides of the thumb?
C6
Which dermatome supplies the first two fingers and the corresponding section of the arm?
C7
Which dermatome supplies the last two fingers (ring & pinky) and the corresponding section of the arm?
C8
Which group of lymph nodes drains the little finger?
Anterior/pectoral group
Which group of lymph nodes drains the breast?
Lateral aspect = Anterior/pectoral group
Medial aspect= posterior/subscapular group
Name the different parts of the scapula
Which part of the clavicle is weakest and commonly breaks (fractures) during a fall?
The middle 1/3rd of the clavicle
It is the thinnest region and lacks muscular support
What type of synovial joint are the acromioclavicular (AC) and sternoclavicular (SC) joints?
AC joint plane synovial
SC joint saddle synovial
Name the muscles which elevate the scapula
Trapezius, elevator scapulae
Name the muscle which depresses the scapula
Pectoralis minor
Name the muscle which protracts the scapula
Serrates anterior
Name the muscles that retract the scapula
Trapezius (middle fibres) and Rhomboids
Name the muscle responsible for shoulder shrugging
Trapezius
name the muscles responsible for medial (downward) rotation of scapula
Levator scapulae
Rhomboid major and minor
Pectorals major
Name the muscles
What is the name of the rim of cartilage surrounding the glenoid cavity?
Glenoid labrum
What kind of cartilage is the labrum made of?
Fibrocartilage
What is the function of the glenoid labrum
Stabilisation of the shoulder joint by increasing the depth of the fossa
Name the ligaments of the shoulder joint
Which part of the shoulder joint capsule is weakest, as it is not protected by muscles or ligaments?
Inferior/posterior region by the triceps head
What is the most common direction of shoulder dislocation?
Anterior
Which bursa communicates with the glenohumeral joint cavity?
The subscapular bursa
What is the role of subacromial bursa?
Serves as a gliding mechanism between the rotator cuff and the coracoacromial arch
Name the 4 rotator cuff muscles as shown below
What movement does supraspinatous allow?
Initiates abduction
What movement does infraspinatus allow?
Lateral rotation
Which movement does subscapularis allow?
Medial rotation and adduction
Which movement does teres minor allow?
Lateral rotation and adduction
What movements does deltoid allow?
Anterior fibres of deltoid flexion and medial rotation at the shoulder joint
Middle fibres abduction the arm at the shoulder joint
Posterior fibres lateral rotation and extension at the shoulder joint
Which nerve supplies deltoid?
Axillary
Where would you test for axillary nerve damage>
Regimental badge area
Where does pectorals major originate and attach?
intertubercular lip of bicipital groove of humerus
What is the function of pectorals minor?
Pulls scapula against ribcage
what is the function of serrates anterior?
Protraction of scapula
Which nerve is damaged in somebody with a winged scapula?
Long thoracic
name the muscles labelled 1-4
Name the function of trapezius
Superior fibres of trapezius elevation the scapula
Middle fibres of trapezius retract the scapula (move it back on the thorax)
Inferior fibres of trapezius pull down the scapula
Which nerve supplies trapezius?
Accessory
Which skull foramen does the accessory nerve leave the skull?
Jugular
Which muscles flex the shoulder? (3)
- pectoralis major
- anterior fibres of deltoid
- coracobrachialis
Which muscles extend the shoulder? (3)
- posterior fibres of deltoid
- lattisimus dorsi
- teres major
Which muscles adduct the shoulder? (4)
- pectoralis major
- latissimus dorsi
- teres major
- coracobrachialis
Which muscles abduct the shoulder?
- Trapezius
2. Supraspinatus
Which muscles cause medial/internal rotation of the shoulder? (5)
- Subscapularis
- Latissimus dorsi
- Pectoralis major
- Teres major
- Anterior deltoid fibres
Which muscles cause lateral/external rotation of the shoulder?
- teres minor
- infraspinatus
- posterior fibres of deltoid
Name the features
Name the muscles labelled 1-4
Nae the origins and attachment of biceps brachii
long head- supraglenoid tuberosity of scapula
Short head- Coracoid process of scapula
inserts- radial tuberosity and bicipital aponeurosis
What is the action of biceps brachii?
Flexes the shoulder and the elbow
Supinates forearm
What are the origin and insertion points of coracobrachialis?
Origin- coracoid process of scapula
Insertion - anterior distal humeral shaft
What is the function of coracobrachialis?
Flex the arm at the shoulder
Which nerve supplies the flexor compartment of the arm?
Musculocutaneous
Which muscle does the musculocutaneous nerve perforate as it enters the arm?
Coracobrachialis
Which muscles does the musculocutaneous nerve run between as it travels down the arm?
Biceps brachii and brachial
What arteries does the brachial artery divide to give?
Brachial divides into radial and ulnar
What is the name of the deep branch of the brachial artery?
Profunda brachii
Which muscle does the profound brachii pass deep to and which nerve does it run alongside?
Passess deep to triceps along with the radial nerve
Which muscles in the forearm are supplied by the ulnar nerve?
flexor carpi ulnaris and medial half of flexor digitorum profundus
name the origins and attachments of triceps
Long head- infraglenoid tubercle of scapula
Medial and lateral heads- humerus
common tendon inserts into olecranon process
What is the action of the triceps and anconeus muscle?
Extension of the elbow
What is the nerve supply to triceps and anconeus?
Radial nerve
Where does the radial nerve enter the arm?
Anterior to the medial head of triceps
which artery does the radial nerve run with?
deep brachial artery
Which feature of the humerus does the radius travel within?
The radial groove
between which structures does the radial nerve emerge from the distal arm?
Between the lateral and medial heads of triceps
What is the characteristic clinical sign of radial nerve injury?
wrist drop
Which nerve is likely to be injured if there is a fracture to the surgical neck of the humerus?
axillary
Which nerve is likely to be injured if there is a fracture to the medial epicondyl?
ulnar nerve
Which nerve is likely to be injured if there is a fracture to the spiral groove of the humerus?
Radial nerve
Name the structures of the cubital fossa
Which vein lies anterior to the roof of the antecubital fossa?
Median cubital vein
At what level does the brachial artery bifurcate into the radial and ulnar artery?
The neck of the radius
Which ligament holds the ulnar in place?
The medial/ulnar collateral ligament
Which ligament holds the head of the radius?
The lateral/radial collateral ligament
Name the ligament that traverses the elbow joint
Annular ligament
Name the muscles that flex the elbow joint (3)
biceps brachii, brachioradialis and brachialis
Which muscles cause extension of the elbow joint
triceps brachii and anconeus
which side of the elbow is upset in tennis elbow?
Lateral (tennis elbow = lateral bursitis)
which side of the elbow is upset in golfers elbow?
Medial (golfer’s elbow = medial epicondylitis)
What type of joints are the radioulnar joints?
Synovial pivot
Which 2 muscles cause supination of the forearm?
Supinator and biceps brachii
Which 2 muscles cause pronation of the forearm?
Pronator quadrates and pronator teres