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Anatomy Learning Objectives > MSK - Upper Limb > Flashcards

MSK - Upper Limb Flashcards

1
Q

Define “the axilla”, and identify the muscles that form its anterior and posterior walls.

A

Axilla is pyramidal space inferior to the shoulder joint and just superior to the hollow that patient’s will refer to as the “armpit”

Anterior: Pectoralis major

Posterior: Teres major

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2
Q

Name the major vessels and nerves that pass through axilla

A

Axillary artery

Axillary vein - continuation of brachial vein (deep vein of arm), becomes axillary vein at lower border of teres major

Components of brachial plexus

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3
Q

What is the arrangement of the apical axillary adipose tissue lymph nodes?

A

Superiorly - drain towards the right lymphatic duct/thoracic duct

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4
Q

What is the arrangement of the central axillary adipose tissue lymph nodes?

A

Drain to apical nodes

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5
Q

What is the arrangement of the basal axillary adipose tissue lymph nodes?

A

Drain to central nodes
- Pectoral - along lateral border of pec minor and receive much lymph from the breast

  • Subscapular - receive lymph from scapular region
  • Humeral - receive most of upper limb lymph
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6
Q

What is the brachial plexus?

A

The brachial plexus supplies the upper limb and is formed from a very specific intertwining of the anterior rami of spinal nerves C5 – T1

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7
Q

From proximal to distal, the brachial plexus consists of?

A

Roots - Trunks - Divisions - Cords - Names Nerves

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8
Q

What are the roots of the brachial plexus?

A

What are the roots of the brachial plexus?

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9
Q

What are the trunks of the brachial plexus?

A

Combinations of roots, which give rise to divisions.

  • Superior = combined anterior rami of C5 & C6 spinal nerves
  • Middle = anterior ramus of C7 spinal nerve
  • Inferior = combined anterior rami of C8 & T1 spinal nerves
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10
Q

What are the divisions of the brachial plexus?

A

What are the trunks of the brachial plexus?

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11
Q

What are the cords of the brachial plexus?

A

The cords are named according to their relationship to axillary artery.

  • Medial = a direct continuation of the anterior division of the inferior trunk
  • Lateral = formed from the anterior divisions of the superior and middle trunks
  • Posterior = formed from the posterior divisions of all three trunks
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12
Q

What are the named nerves of the brachial plexus?

A

The cords combine to give the named nerves of the brachial plexus.

  • The ulnar nerve continues directly from the medial cord
  • The musculocutaneous nerve continues directly from the lateral cord
  • The posterior cord divides into the axillary nerve and radial nerve
  • The medial and lateral cords both contribute the formation of the median nerve
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13
Q

Where are the roots and trunks of the brachial plexus?

A

Lie mainly between the anterior and middle scalene muscles in the root of the neck.

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14
Q

Where are the divisions of the brachial plexus?

A

Immediately posterior to the subclavian vessels in the root of the neck (deep to the clavicle)

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15
Q

Where are the cords of the brachial plexus?

A

Around the axillary artery, which is distal to 1st rib

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16
Q

Which muscles does the musculocutaneous nerve supply?

A

Coracobracialis, biceps brachii, brachialis

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17
Q

Where to the axillary nerves and radial nerves eventually pass into?

A

Posterior compartment of arm

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18
Q

What is the course of the axillary nerve?

A

Lies superior to radial nerve, wraps around posterior aspect of surgical neck of humerus

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19
Q

What injury can damage the axillary nerve?

A

Shoulder dislocation/fractured neck of humerus

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20
Q

What structure does the radial nerve wrap around?

A

Posterior aspect of mid-shat of humerus (may be injured by mid-shaft humeral fracture)

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21
Q

The ulnar nerve is the most medial/lateral of the named nerves of the brachial plexus

A

MEDIAL

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22
Q

The ulnar nerves passes anteriorly/posteriorly into medial/lateral aspect of arm

A

POSTERIORLY

MEDIAL

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23
Q

What part of the ‘M-shaped” configuration of the named nerves within the axilla does the median nerve form?

A

Middle

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24
Q

What are the bones of the pectoral (shoulder) girdle?

A

Scapula, clavicle, manubrium of sternum

25
Q

By what 3 joints does the pectoral girdle permit articulation of upper limb with appendicular skeleton?

A

Glenohumeral, acromioclavicular, sternoclavicular

Offer increased range of movement for hand function

26
Q

What is the role of the pectoral girdle?

A

Maintain relatively lateral position of upper limb

27
Q

How is the pectoral girdle stabilised?

A

By providing attachment points for ligaments and muscles

28
Q

What role does the posterior (spinal) part of the deltoid play in shoulder movement?

A

Extension at shoulder

29
Q

What role does the middle (acromial) part of the deltoid play in shoulder movement?

A

ABduction at shoulder (taking over from spuraspinatus beyond 15 degrees)

30
Q

What role does the anterior (clavicular) part of the deltoid play in shoulder movement?

A

Mainly flexion at shoulder

31
Q

What role does the ascending trapezius play in shoulder movement?

A

Scapular depression

32
Q

What role does the middle trapezius play in shoulder movement?

A

Scapular retraction

33
Q

What role does the descending trapezius play in shoulder movement?

A

Scapular elevation

34
Q

What movement do the ascending and descending parts of the deltoid co-ordinate to produce?

A

Superior rotation of glenoid fossa

35
Q

What movements does the Levator scapulae produce?

A

Elevation of scapula and inferior rotation of glenoid fossa

36
Q

What movements do the Rhomboids produce?

A

Major - retraction of scapula and inferior rotation of glenoid fossa

Minor - retraction of scapula and inferior rotation of glenoid fossa

37
Q

What muscles make up the rotator cuff?

A 
SITS 
Supraspinatus 
Infraspinatus 
Teres minor 
Subscapularis
38
Q

What does the supraspinatus do?

A

First 15 degrees of abduction at shoulder

39
Q

What do the teres minor/ infraspinatus do?

A

Stabilise head of humerus in glenoid/lateral rotation at shoulder

40
Q

What does the subscapularis do?

A

Stabilise head of humerus in glenoid/medial rotation at shoulder

41
Q

What does the teres major do?

A

ADduction/medial rotation at shoulder

42
Q

What are the non-rotator cuff muscles that attach to the pectoral girdle?

A

Teres major, pectoralis major, pectoralis minor and serratus anterior

43
Q

Why must the scapula rotate to allow for full adduction/abduction of the upper limb to occur?

A

So that the glenoid fossa faces more inferiorly/superiorly respectively. Superior rotation of the glenoid is required to prevent the greater tubercle of the humerus from impinging on the acromion of the scapula i.e. without superior rotation of the scapula we would be unable to fully abduct our upper limb.

44
Q

What is the distal insertion of the supraspinatus/infraspinatus/teres minor?

A

Greater tubercle of humerus

45
Q

What is the distal insertion of the subscapularis?

A

Lesser tubercle of humerus

46
Q

What is the innervation of the rotator cuff muscles?

A

Branches of brachial plexus

47
Q

What is “painful arc syndrome”?

A

Impingement of supraspinatus tendon between the humerus and the acromion process can lead to “painful arc syndrome”; patients with this condition typically complain of pain during 50-130° of abduction.

48
Q

What will a patient with supraspinatus paralysis/tendon tear do to initiate ABduction?

A

Throw upper limbs to the side

49
Q

What function to the distal tendon attachments of the rotator cuff muscles serve in the shoulder joint?

A

Strengthens it

50
Q

What is the most common rotator cuff injury?

A

Partial tear or complete rupture of supraspinatus tendon

51
Q

Understand the glenohumoral joint

State the type of joint

A

ssd

52
Q

Understand the glenohumoral joint

Describe the key osteology

A

dsds

53
Q

Understand the glenohumoral joint
Identify the principle ligaments (coraco-clavicular, coraco-acromial, coraco-humeral & glenohumeral) and how they affect stability

A

sdds

54
Q

Understand the glenohumoral joint

Know the location of the subacromial bursa and its relationship to the supraspinatus tendon

A

dsd

55
Q

Understand the glenohumoral joint
Identify the glenoid labrum and anatomical neck of the humerus, and know they represent the attachments of the joint capsule

A

dsds

56
Q

Understand the glenohumoral joint
Understand why dislocation of the shoulder joint is common and may be associated with axillary nerve injury. Know how to test axillary nerve motor and sensory function.

A

sdds

57
Q

Understand the elbow joint

Describe the bony anatomy of the elbow and radioulnar joints and the ligaments mentioned in this manual.

A

dssd

58
Q

Understand the elbow joint
Be aware that the elbow joint can dislocate and that the head of the radius can dislocate from within the annular ligament. Know that this is common in children.

A

dd

Anatomy Learning Objectives (13 decks)

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