MSK Upper Limb Flashcards by Niamh Armstrong

Which 2 muscles make up the anterior wall of the axilla?

Pectoralis major and minor

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Which 3 muscles make up the posterior wall of the axilla?

Subscapularis, theres major and latissimus dorsi

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What structures form the medial wall of the axilla?

Thoracic wall and serrates anterior

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Name the structure that forms the lateral wall of the axilla

Intertubercular sulcus of humerus

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The axillary artery is the continuation of which artery?

Subclavian artery

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At what anatomical point does the axillary artery begin?

Lateral border of the first rib

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The axillary artery continues beyond the axilla as which vessel?

Brachial artery

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At what anatomical point does the axillary artery become the brachial artery?

Posterior border of teres major

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What forms the brachial plexus?

The VENTRAL rami of C5-T1

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Which nerve roots form the upper trunk of the brachial plexus?

C5 & 6

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Which root of the brachial plexus form the middle trunk?

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Which roots of the brachial plexus form the lower trunk?

C8 & T1

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Describe the different parts that the brachial plexus is split into

Roots, Trunks, Divisions, cords, terminal branches

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Which artery are the trunk divisions of the brachial plexus named in relation to?

axillary artery in the axilla.

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An injury to which trunk of the brachial plexus results in Erb’s palsy?

Upper

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An injury to which trunk of the brachial plexus results in Klumpke’s palsy?

Lower

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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

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Blood shunts between which vessels in the cubital fossa

From cephalic to basilic

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Which vein arises from the lateral end of the dorsal venous arch?

Cephalic

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Which vein arises from the medial end of the dorsal venous arch?

basilic

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What is the name of the vein which shunts blood between the cephalic and basilic veins?

Median cubital vein

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Which dermatome supplies both sides of the thumb?

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Which dermatome supplies the first two fingers and the corresponding section of the arm?

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Which dermatome supplies the last two fingers (ring & pinky) and the corresponding section of the arm?

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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?

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?

Medial 1/3 of clavicle, sternum & costal cartilage of first 6 ribs - 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)

1. pectoralis major 2. anterior fibres of deltoid 3. coracobrachialis

Which muscles extend the shoulder? (3)

1. posterior fibres of deltoid 1. lattisimus dorsi 2. teres major

Which muscles adduct the shoulder? (4)

1. pectoralis major 2. latissimus dorsi 3. teres major 4. coracobrachialis

Which muscles abduct the shoulder?

1. Trapezius | 2. Supraspinatus

Which muscles cause medial/internal rotation of the shoulder? (5)

1. Subscapularis 2. Latissimus dorsi 3. Pectoralis major 4. Teres major 5. Anterior deltoid fibres

Which muscles cause lateral/external rotation of the shoulder?

1. teres minor 2. infraspinatus 3. 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