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Anatomy for resit cause your stupid > MSK Upper Limb > Flashcards

MSK Upper Limb Flashcards

1
Q

What is the axilla a passageway for?

A

Vessels

Nerves

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2
Q

Anterior border of the axilla

A

Pectoralis major

Pectoralis minor

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3
Q

Posterior border of the axilla

A

Teres major
Scapularis
Latissmus dorsi

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4
Q

Medial wall of axilla

A

Thoracic wall

Serratus anterior

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5
Q

Lateral wall of axilla

A

Intertubercular sulcus of the humerus

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6
Q

What is the axillary artery a continuation of?

A

Subclavian artery

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7
Q

When does the axillary artery begin?

A

Lateral border of the 1st rib

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8
Q

When does the brachial artery?

A

Beyond the margin of the teres major

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9
Q

Nerve roots of the brachial plexus

A

C5-T1

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10
Q

What does the brachial plexus innervate?

A

The upper limb

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11
Q

Order of the brachial plexus

A 
Roots
Trunks
Divisions
Cords
Branches
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12
Q

What are the trunks of the brachial plexus?

A

Superior
Middle
Inferior

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13
Q

What are the divisions of the brachial plexus?

A

Anterior

Posterior

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14
Q

What are the cords of the brachial plexus?

A

Lateral
Posterior
Medial

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15
Q

Branches of the brachial plexus

A 
Musculocutaneous 
Axillary 
Medial
Radial
Ulnar
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16
Q

What does injury to the superior trunk cause?

A

Erb’s palsy

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17
Q

What does injury to the lower trunk cause?

A

Klumpke’s palsy

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18
Q

The cords of the brachial plexus are named in relation to what?

A

The axillary artery in the axilla

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19
Q

What are in close relation to the brachial plexus?

A

Anterior and posterior scalenes

Subclavian artery

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20
Q

What end of the dorsal venous arch does the cephalic vein make up?

A

Lateral end

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21
Q

What end of the dorsal venous arch does the basilic vein make up?

A

Medial end

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22
Q

What are superficial veins of the upper limb used for?

A

IV injections for transfusion

Blood testing

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23
Q

What is the median cubital vein?

A

Large communicating vein which shunts blood from the basilic vein to the cephalic vein

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24
Q

What is a dermatome?

A

An area of skin supplied by one spinal segment

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25
Q

What lymph nodes are the upper limbs drained by?

A

Axillary nodes

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26
Q

5 groups of axillary nodes

A 
Anterior/pectoral group
Posterior/subscapular group 
Apical group 
Central group 
Lateral/humeral group (Axillary)
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27
Q

Another name for the shoulder girdle

A

Pectoral girdle

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28
Q

Function of the shoulder girdle

A

A set of bones that connect the upper limb to the axial skeleton on each side

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29
Q

What type of cartilage is the glenoid labrum?

A

Fibroelastic cartilage

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30
Q

Where is the clavicle commonly fractured?

A

Middle 1/3rd

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31
Q

What type of joint is the acromioclavicular joint?

A

Synovial plane joint

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32
Q

What type of joint is the sternoclavicular joint?

A

Synovial saddle joint

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33
Q

What type of joint does the sternoclavicular joint ACT as?

A

Synovial ball and socket joint

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34
Q

What ratio do the scapula and humerus move in?

A

1:2 ratio

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35
Q

What is the scapulo-humeral rhythm?

A

Beyond approx. 30 degrees, for every 3 degrees of abduction, 2 degrees occur at the shoulder joint and 1 degree at the scapulothoracic joint

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36
Q

What is the scapulo-thoracic joint?

A

The movement of the scapula on the thoracic wall

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37
Q

What elevates the scapula?

A

Levator scapulae
Serratus anterior
Rhomboids
Superior fibres of the trapezius

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38
Q

What depresses the scapula?

A

Pectoralis major
Pectoralis minor
Lattissimus dorsi
Inferior fibres of the trapezius

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39
Q

What retracts the scapula?

A

Middle fibres of the trapezius
Rhomboids
Lattisimus dorsi

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40
Q

What causes lateral (upward) rotation of the glenoid cavity?

A

Trapezius (upper and lower fibres)

Serratus anterior

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41
Q

What causes medial (downward) rotation of the glenoid cavity?

A

Gravity
Levator scapulae
Rhomboids
Pectoralis major

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42
Q

Another name for the shoulder joint

A

Gleno-humeral joint

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43
Q

What type of joint is the shoulder joint?

A

Synovial ball and socket joint

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44
Q

What is the ball and what is the socket of the shoulder joint?

A

Ball - head of humerus

Socket - Glenoid cavity

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45
Q

Function of the glenoid labrum

A

Deepens the glenoid cavity and effectively increases the surface of the shoulder joint

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46
Q

Ligaments of the shoulder joint

A 
Transverse humeral ligament 
Glenohumeral ligament 
Coracoacromial ligament 
Coracoclavicular ligament 
Coracohumeral ligament
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47
Q

What does the coracoacromial ligament strengthen?

A

The superior aspect

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48
Q

What does the coracohumeral ligament strengthen?

A

Superior aspect

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49
Q

Function of the coracoclavicular ligament?

A

Maintains alignment of the clavicle

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50
Q

What is the weak area of the shoulder and why?

A

The glenohumeral ligament

Not supported by any muscles

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51
Q

What does the glenohumeral ligament strengthen?

A

The anterior aspect

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52
Q

What makes up the coracoacromial arch?

A

Acromion
Coracoid process
Coracoacromial ligament

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53
Q

Function of the coracoacromial arch

A

To prevent upward displacement of the humeral head

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54
Q

Two bursae of the shoulder

A

Subacromial (subdeltoid) bursae

Subscapular bursae

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55
Q

What shoulder bursae communicates with the shoulder cavity?

A

Subscapular bursae

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56
Q

What shoulder bursae is injured in a rotator cuff tear?

A

Subacromial bursae

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57
Q

What is the subacromial/deltoid bursae related to?

A

Supraspinatus tendon

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58
Q

What are the rotator cuff muscles?

A

Subscapularis
Supraspinatus
Infraspinatus
Teres minor

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59
Q

Action of the anterior fibres of the deltoid

A

Flexion of shoulder

Internal rotation of shoulder

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60
Q

Action of the middle fibres of the deltoid

A

Abduction of the shoulder

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61
Q

Action of the posterior fibres of the deltoid

A

Extension at shoulder joint

External rotation of shoulder joint

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62
Q

Innervation of the deltoid

A

Axillary nerve

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63
Q

How can the axillary nerve be damaged?

A

Fracture of the surgical neck of the humerus

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64
Q

How can you test for axillary nerve function?

A

Deltoid

Test for sensation on lateral side of proximal forearm

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65
Q

Actions of pectoralis major on the shoulder

A

Adduction
Internal rotation
Flexion

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66
Q

Borders of the deltopectoral triangle

A

Deltoid
Clavicle
Pec major

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67
Q

What is found in the deltopectoral triangle and what is it used for?

A

Cephalic vein

Used for central lines

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68
Q

Actions of serratus anterior

A

Protraction of scapulae

Stabilises scapulae during limb movements and keeps it pulled against the thoracic cage

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69
Q

What innervates the serratus anterior?

A

Long thoracic nerve

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70
Q

Damage to the long thoracic nerve causes what?

A

Winging of scapulae

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71
Q

Pathology of winging of scapulae

A

Medial border of scapulae moves laterally and posteriorly away from thoracic wall

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72
Q

What procedure can result in winging of the scapulae?

A

Radical mastectomies

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73
Q

What do superior fibres of the trapezius do?

A

Elevate scapulae

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74
Q

What do middle fibres of the trapezius do?

A

Retract scapulae

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75
Q

What do inferior fibres of the trapezius do?

A

Depress the scapulae

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76
Q

Innervation of trapezius

A

Accessory nerve

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77
Q

Roots of accessory nerve

A

CN XI

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78
Q

Action of teres major on shoulder

A

Adduction
Extension
Medial rotation

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79
Q

Action of lattisimus dorsi on the shoulder

A

Extension
Adduction
Medial rotation

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80
Q

What flexes the shoulder?

A

Anterior fibres of deltoid
Serratus anterior
Pectoralis major

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81
Q

What extends the shoulder?

A

Posterior fibres of deltoid
Lattisimus dorsi
Teres major

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82
Q

What adducts the shoulder?

A

Lower pec major
Latissimus dorsi
Teres major
Teres minor

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83
Q

What abducts the shoulder?

A

Middle fibres of the deltoid

Supraspinatus

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84
Q

What laterally/externally rotates the shoulder?

A

Teres minor
Infraspinatus
Posterior fibres of the deltoid
Lower trapezius

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85
Q

What medially/internally rotates the shoulder?

A

Anterior fibres of deltoid
Teres major
Lattisimus dorsi
Pectoralis major

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86
Q

What does the long head of the biceps brachii arise from?

A

Supraglenoid tubercle

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87
Q

What does the short head of the biceps brachii arise from?

A

The coracoid process

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88
Q

Where do the two heads of the biceps brachii tendon insert?

A

The tuberosity of the radius

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89
Q

Actions of the biceps brachii

A

Flexes shoulder
Flexes elbow
Supinator of radio-ulnar joint

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90
Q

Innervation of biceps brachii

A

Musculocutaneous nerve

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91
Q

Musculocutaneous nerve roots

A

C5-C7

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92
Q

Axillary nerve roots

A

C5 + C6

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93
Q

What cord is the musculocutaneous nerve from?

A

Lateral cord

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94
Q

What cord is the axillary nerve from?

A

Posterior cord

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95
Q

Muscles of the anterior arm

A

Biceps brachii
Brachialis
Coracobrachialis

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96
Q

Root values of the median nerve

A

C5-T1

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97
Q

Median nerve cord

A

Lateral and medial cords

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98
Q

Root values of the radial nerve

A

C5-T1

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99
Q

Radial nerve cord

A

Posterior cord

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100
Q

Ulnar nerve roots

A

C8-T1

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101
Q

Ulnar nerve cord

A

Medial cord

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102
Q

Attachments of the coracobrachialis

A

From the coracoid process

Inserted into the medial margin of the humerus at about its middle

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103
Q

Actions of coracobrachialis

A

Flexion of shoulder

Adduction of shoulder

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104
Q

Innervation of coracobrachialis

A

Musculocutaneous

105
Q

Innervation of brachialis

A

Musculocutaneous

106
Q

Attachments of brachialis

A

Arises from front of the distal 1/2 of the shaft of the humerus

107
Q

Actions of brachialis

A

Flexion of elbow

108
Q

What does the musculocutaneous nerve perforate?

A

Coracobrachialis

109
Q

What does the musculocutaneous nerve descend between?

A

Brachialis and biceps brachii

110
Q

What does the musculocutaneous nerve continue as?

A

Lateral cutaneous nerve of the forearm

111
Q

What does the musculocutaneous nerve provide sensation to?

A

Lateral side of forearm

112
Q

4 main nerves of the arm

A

Musculocutaneous
Radial
Ulnar
Median

113
Q

What is the brachial artery a direct continuation of?

A

The axillary artery

114
Q

When does the brachial artery begin?

A

Lower border of teres major

115
Q

When does the brachial artery end?

A

In the cubital fossa close to the neck of the radius

116
Q

What does the brachial artery divide into?

A

Radial and ulnar arteries

117
Q

What is a deep artery which is a branch of the brachial artery?

A

Profunda brachii artery

118
Q

On specimens, what does the median nerve look like?

A

Very thick

119
Q

Where does the median nerve arise?

A

The axilla

120
Q

Where does the median nerve descend?

A

along lateral side of axillary artery and upper part of brachial artery
Enters cubital fossa

121
Q

Where does the ulnar nerve descend?

A

Along the medial side of the brachial artery (Artery lateral to nerve)
Enters posterior compartment of arm due to medial intermuscular septum and runs along the medial head of the triceps

122
Q

How can the radial nerve be injured?

A

Injury to the radial groove of the humerus

123
Q

How can the axillary nerve be injured?

A

By damage to the surgical neck of the humerus

124
Q

How can the ulnar nerve be injured?

A

Damage to the medial epicondyle

125
Q

Contents of the cubital fossa

A 
Brachial artery 
Median nerve
Radial nerve
Biceps brachii
Pronator teres 
Supinator 
Biceps brachii
Brachioradialis 
Cubital vein
126
Q

What can the cubital vein be used for?

A

IV injections

127
Q

Base of cubital fossa

A

Imaginary line between the two epicondyles

128
Q

Median border of border of cubital fossa

A

Lateral border of pronator teres

129
Q

Lateral border of cubital fossa

A

Medial border of brachioradialis

130
Q

Innervation of the triceps brachii

A

Radial nerve

131
Q

Heads of the triceps brachii

A

Long
Medial
Lateral

132
Q

Where does the long head of the triceps brachii insert?

A

Infraglenoid tubercle

133
Q

Where does the triceps tendon insert?

A

Olecranon process of ulna

134
Q

Action of triceps brachii

A

Extension at elbow

135
Q

Innervation of anconeus

A

Radial nerve

136
Q

Action of anconeus

A

Extension of elbow

137
Q

What accompanies the radial nerve in the radial groove?

A

Profunda brachii artery

138
Q

Injury to the radial nerve causes what?

A

Wrist drop

139
Q

Pathway of the radial nerve

A

Enters arm anterior to triceps
Runs with the profunda femoris artery
Curves around the midshaft region of the humerus in the radial groove

140
Q

What type of joint is the elbow joint?

A

Synovial hinge

141
Q

What muscles flex the elbow?

A

Biceps brachii
Brachialis
Brachioradialis

142
Q

What muscles extend the elbow?

A

Triceps brachii

Anconeus

143
Q

What is the function of the annular ligament?

A

Holds the head of the radius

144
Q

What are the three ligaments on either side of the elbow?

A

Ulnar Collateral ligament
Radial collateral ligament
Annular ligament

145
Q

What type of joints are the proximal and distal radio-ulnar joints?

A

Synovial pivot

146
Q

How would one dislocate their radius from proximal radio-ulnar joint?

A

Pulled elbow or

Subluxation of radial head

147
Q

What muscles supinate the radio-ulnar joints?

A

Biceps brachii

Supinator

148
Q

What is the main supinator of the radio-ulnar joint?

A

Biceps brachii

149
Q

What are the assisting muscles that cause supination of the radio-ulnar joint?

A

Extensor pollicus longus

Extensor carpi radialis longus

150
Q

What muscles pronate the radio-ulnar joints?

A 
Pronator teres
Pronator quadratus 
Flexor carpi radialis
Palmaris longus 
Brachioradialis
151
Q

Innervation of the pronator teres

A

Median nerve

152
Q

Innervation of flexor carpi radialis

A

Median nerve

153
Q

Innervation of flexor carpi ulnaris

A

Ulnar nerve

154
Q

Innervation of palmaris longus

A

Median nerve

155
Q

Action of the pronator teres

A

Pronation

156
Q

Actions of flexor carpi ulnaris

A

Flexion of wrist

Adduction of wrist

157
Q

Actions of flexor carpi radialis

A

Flexion of wrist

Abduction of wrist

158
Q

Action of the palmaris longus

A

Flexion of wrist

159
Q

Which compartment does the Brachioradialis belong to?

A

Extensor compartment

160
Q

Innervation of Brachioradialis

A

Radial nerve

161
Q

Action of Brachioradialis

A

Flexion at elbow

162
Q

What is the flexor digitorum superficialis superficial to?

A

Flexor digitorum profundus

163
Q

Where does the FDS attach to?

A

middle/second phalanges of the 4 fingers

164
Q

Actions of the Flexor digitorum superficialis

A

Flexion of wrist
Flexion at metacarpalphalangeal joints
Flexion at interphalangeal joints

165
Q

What are the deep muscles of the forearm in contact with?

A

Bones and interosseous membranes

166
Q

What are the deep muscles of the forearm?

A

Flexor digitorum profundus
Flexor pollicus longus
Pronator quadratus

167
Q

Actions of flexor digitorum profundus

A

Flexes phalanges

Flexes wrist

168
Q

Innervation of the flexor digitorum profundus

A

Medial (4th + 5th digits) = ulnar nerve

Lateral (2nd + 3rd digits) = median nerve

169
Q

Innervation of the flexor pollicus longus

A

Median nerve

170
Q

Action of the flexor pollicus longus

A

Flexion of thumb

171
Q

Action of the pronator quadratus

A

Pronation

172
Q

Innervation of pronator quadratus

A

Median nerve

173
Q

Attachments of the pronator quadratus

A

Origin at ulna

Passes across to be inserted into radius

174
Q

Where does the median nerve lie in relation to the brachial artery?

A

Superomedial to the artery

175
Q

Where does the ulnar nerve enter the forearm?

A

By passing between the heads of the flexor carpi ulnaris muscle

176
Q

Where does the ulnar nerve lie in relation to the ulnar artery?

A

Nerve lies medial to the artery

177
Q

Where does the brachial artery divide?

A

At the neck of the radius

178
Q

Where is the radial pulse felt?

A

Medial to the tendon of the flexor carpi radialis muscle

179
Q

Bones forming the borders of the carpal tunnel

A

Scaphoid and trapezium on the lateral side

Pisiform and hamate on the medial side

180
Q

What is the flexor retinaculum?

A

A strong fibrous band which converts the concavity of the palmar surface (carpal bones) into a channel - the carpal tunnel

181
Q

Contents of the carpal tunnel

A

Median nerve
4 tendons of the FDS
4 tendons of the FDP
1 tendon of the FPL

182
Q

What is carpal tunnel syndrome caused by?

A

Any lesion that significantly reduces the size of the carpal tunnel

183
Q

Most sensitive structure of the carpal tunnel affected in carpal tunnel syndrome

A

Median nerve

184
Q

What is the palmar fascia (aponeurosis) a continuation of?

A

Palmaris longus muscle

185
Q

What make up the thenar eminence?

A

Abductor pollicus brevis
Flexor pollicus brevis
Oppenens pollicus

186
Q

What innervates the thenar muscles?

A

Median nerve

187
Q

What makes up the hypothenar eminence?

A

Abductor digiti minimi
Flexor digiti minimi
Oppenens digiti minimi

188
Q

What innervates the hypothenar eminence?

A

Ulnar nerve

189
Q

Action of abductor digiti minimi

A

Abduction of pinkie

190
Q

Action of flexor digiti minimi

A

Flexes MCP of pinkie

191
Q

Action of opponens digiti minimi

A

Flexes pinkie towards palm, producing oppositio

192
Q

Two heads of the adductor policus

A

Transverse

Oblique

193
Q

Innervation of adductor policus

A

Ulnar nerve

194
Q

Where does each lumbrical originate from?

A

The tendon of the flexor digitorum profundus

195
Q

Actions of lumbricals

A

Flex fingers at the MCP joint and SIMILTANEOUSLY

Extend the interphalangeal joints of digitis 2-5

196
Q

Innervation of lumbricals

A

medial 2 lumbricals = ulnar nerve

Lateral 2 lumbricals = median nerve

197
Q

What are the interossei bones present between?

A

The metacarpal bones

198
Q

How many interossei do we have?

A

4 dorsal

3 palmar

199
Q

Innervation of interossei

A

Ulnar nerve

200
Q

Action of dorsal interossei

A

DAB

Abduction

201
Q

Action of palmar interossei

A

PAD

Adduction

202
Q

What artery is the main contributor to the superficial palmar arch?

A

Ulnar artery

203
Q

What artery is the main contributor to the deep palmar arch?

A

Radial artery

204
Q

What does the radial nerve supply on the hand?

A

Skin on the dorsal aspect of the hand

205
Q

How does the median nerve enter the hand?

A

Through the carpal tunnel

206
Q

Another name for the wrist joint

A

Radiocarpal joint

207
Q

What type of joint is the wrist joint?

A

Synovial condyloid

208
Q

Articular parts of the wrist joint

A 
Proximal = radius
Distal = proximal row of carpal bones
209
Q

3 bones of the hand

A

Carpals
Metacarpals
Phalanges

210
Q

Which carpal bone is most commonly fractured and what does this mean it is at risk of?

A

Scaphoid

Avascular necrosis

211
Q

Blood supply to the scaphoid

A

Distal to proximal

212
Q

What type of joint is the 1st CMC joint?

A

Synovial saddle

213
Q

What type of joint is the 2nd-5th CMC joints?

A

Synovial condyloid

214
Q

What type of joints are the MCP joints?

A

Synovial condyloid

215
Q

What type of joints are the interphalangeal joints?

A

Synovial hinge

216
Q

What innervates the posterior forearm muscles?

A

Radial nerve

217
Q

Action of extensor carpi radialis longus and brevis

A

Extension of wrist

Abduction of wrist

218
Q

Action of extensor carpi ulnaris

A

Extension of wrist

Adduction of wrist

219
Q

Action of extensor digitorum

A

Extends medial 4 digits at MCP joint

220
Q

Action of Brachioradialis

A

Flexion at elbow

221
Q

Innervation of brachioradialis

A

Radial nerve

222
Q

Innervation of supinator

A

Radial nerve

223
Q

Action of extensor digiti minmi

A

Extends 5th finger at MCP joint

224
Q

What does the supinator cover?

A

Shaft of radius completely EXCEPT on medial side

225
Q

Action of supinator

A

Supination of radio-ulnar joints

226
Q

What does the radial nerve divide into and where?

A

Superficial and deep branches

In the cubital fossa

227
Q

What is the deep branch of the radial nerve also called?

A

Posterior intraosseous nerve

228
Q

Features of the superficial branch of the radial nerve

A

Sensory

Is distributed on skin on dorsum of hand

229
Q

What occurs on the dorsum of the hand from the extensor muscle tendons?

A

Synovial sheaths

230
Q

What results in a “dinner fork deformity”?

A

Colles fracture of distal radius

231
Q

What is the anatomical snuffbox?

A

A shallow depression on the lateral aspect of the wrist when the thumb is extended fully

232
Q

What binds the anatomical snuffbox laterally?

A

Abductor pollicus longus

Extensor pollicus brevis

233
Q

What binds the anatomical snuffbox laterally?

A

Extensor pollicus longus

234
Q

What two carpal bones are in the anatomical snuffbox?

A

Scaphoid

Trapezium

235
Q

What lies on the floor of the anatomical snuffbox?

A

Radial artery

236
Q

What are the extensor compartment thumb muscles innervated by?

A

Radial nerve

237
Q

When the 4 extensor digitorum tendons flatten, what do they form and what are these?

A

Form extensor expansions
These are triangular tendinous aponeurosis that wraps around the dorsum and sides of the head of the metacarpal and base of the proximal phalanx

238
Q

What muscles attach to the extensor expansion muscle?

A

Lumbricals
Extensor indices
Dorsal interossei
Palmar interossei

239
Q

When may compression of the axillary artery be necessary?

A

When profuse bleeding occurs due to severe injury to the upper limb

240
Q

What is common in the infection of the upper limb?

A

Enlargement of axillary lymph nodes

241
Q

What does erbs palsy result in?

A

Waiter’s tip position

242
Q

What is the presentation of waiters tip position?

A

Medially rotated with wrist flexed

243
Q

What causes upper brachial plexus injury and give some examples?

A

Undue hyperextension of head from shoulder
Fall on the shoulder
Birth injury
During anaesthesia

244
Q

What causes klumpkes palsy?

A

Undue abduction of arm

245
Q

What muscles are affected in klumpkes palsy?

A

Intrinsic muscles of hand

Ulnar flexors of wrists and fingers

246
Q

Branches of the lateral cord of brachial plexus

A

Lateral pectoral
Lateral root of medial nerve
Musculocutaneous

247
Q

Branches of the medial cord of brachial plexus

A 
Medial pectoral 
Ulnar
Medial cutaneous nerve of arm 
Medial cutaneous nerve of forearm 
Median
248
Q

Branches of posterior cord of brachial plexus

A

Thoracodorsal nerve
Axillary
Radial
Subscapular nerve

249
Q

What makes up the coracoclavicular ligament?

A

Trapezoid ligament

Conoid ligament

250
Q

What is the conoid tubercle an attachment for?

A

Conoid ligament

251
Q

What are the attachments of the conoid ligament?

A

Binds the clavicle to the coracoid process of the scapula

252
Q

Function of the shoulder joint ligaments

A

Strengthen and ease the movements at the shoulder joint

253
Q

What are shoulder ligaments made from?

A

Thickening of joint capsule

254
Q

What nodes would drain the infection of the pinkie?

A

Superficial inguinal nodes

255
Q

What nodes would drain a boil in the scapular region?

A

Axillary

256
Q

What nodes would drain the medial part of the breast close to the sternum?

A

Internal thoracic nodes

257
Q

What nodes would drain the lateral part of the breast close to the axilla?

A

Axillary

258
Q

Lymphatic drainage of above the umbilicus?

A

Axillary

259
Q

Lymphatic drainage of below the umbilicus

A

Superficial inguinal

Anatomy for resit cause your stupid (9 decks)

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