Organization of the Upper Limb

Question 1

What is the single osseous articulation of the scapula to the thorax?

Answer 1

sternoclavicular articulation

Question 2

What structures uphold the stability of the upper limb?

Answer 2

• sternoclavicular joint

- muscles which attach the scapula to the thorax

Question 3

What kind of joint is present in the shoulder?

Answer 3

ball and socket joint

Question 4

What movements does the ball and socket joint of the should allow?

Answer 4

1. reaching above the head or swinging while supporting the body
2. pulling objects toward the body or pushing objects away in all planes

Question 5

What kind of joint is the elbow?

Answer 5

hinge joint

Question 6

What does the elbow allow?

Answer 6

allows us to bring objects closer to the trunk and face

Question 7

What allows pronation and supination?

Answer 7

pivot joint of radius and ulna

Question 8

What allows greater flexibility during grasping, pushing off or for support?

Answer 8

multiple bones at the wrist and hand

Question 9

What is the main function of superficial fascia?

Answer 9

attach the skin to the body

Question 10

What are the two layers of the superficial fascia?

Answer 10

• superficial ‘fatty’ layer

- deeper ‘membranous’ layer

Question 11

The deep fascia of the upper limb is a continuation of what?

Answer 11

muscular fascia of the trapezius, scapular muscles, latissimus dorsi, and pectoral muscles.

Question 12

What structures does the deep fascia attach to?

Answer 12

boney prominences not covered by muscle

Question 13

What are some boney prominences that deep fascia attach to?

Answer 13

acromion, clavicle, supracondylar lines, humeral epicondyles, olecranon process, interosseous crests (radius, ulna), posterior shaft of the ulna, distal radius and ulna, tuberosities of the carpal bones (flexor retinaculum), distal portions of all proximal phalanges.

Question 14

What are the regional names of deep fascia?

Answer 14

brachial, antebrachial, thenar, hypothenar

Question 15

What special structures does deep fascia form?

Answer 15

• intermuscular septae in arm and forearm
• interosseous membrane in antebrachium
• palmer capal ligament
• flexor and extensor retinaculum of carpus
• palmer aponeurosis of the hand

Question 16

What compartments does the deep fascia create in the arm and forearm?

Answer 16

flexor and extensor

Question 17

What compartments does the deep fascia create in the hand?

Answer 17

thenar, hypothenar, central, and adductor-interosseous

Question 18

What are the transitional zones of the upper limb?

Answer 18

axilla, cubital fossa, carpal tunnel, palmar spaces

Question 19

What is the transitional space between the root of the neck and upper limb?

Answer 19

Axilla

Question 20

What are the boundaries of the axilla space?

Answer 20

tetrahedral space: body wall, pectoral and scapular musculature, humerus and axillary fascia

Question 21

What does the axilla space contain?

Answer 21

vessels, nerves, and lymphatics to and from neck and upper limb

Question 22

What is the transitional zone between the brachium and forearm?

Answer 22

cubital fossa

Question 23

What are the boundaries of the cubital fossa?

Answer 23

triangular space: arm and forearm musculature

Question 24

What does the cubital fossa contain?

Answer 24

• bifurcation of the brachial a into radial and ulnar aa.
• biceps tendon
• median nerve

Question 25

What is the transitional zone between the forearm and hand?

Answer 25

carpal tunnel

Question 26

What forms the “tunnel” of carpal tunnel zone?

Answer 26

carpal bones (floor) and flexor retinaculum (roof)

Question 27

What runs through the carpal tunnel?

Answer 27

• median nerve

- tendons of the forearm muscles that move fingers

Question 28

What is the major artery that supplies the upper limb?

Answer 28

subclavian a

- name changes as passes through named regions (axillary, brachial etc.)

Question 29

How are the effects of compression avoided when it comes to arterial scheme of the upper limb?

Answer 29

anastomotic branches from principle artery at major jointed areas (elbow)

Question 30

How doe arteries travel through the arm?

Answer 30

within areas of deep fascia parallel to the bones (protection)

Question 31

How are deep veins named?

Answer 31

for the arteries with travel with

Question 32

How are deep veins in the forearm organized?

Answer 32

doubled on either side of the artery (medial and lateral branch)

Question 33

What is the purpose of valves in veins?

Answer 33

prevents blood from coursing in the opposite direction (lack of venous pressure/resistance)

Question 34

What are the two sets of lymphatics in the upper limb? Where are they located?

Answer 34

1. superficial - skin

2. deeper - parallels arteries

Question 35

Where are lymph nodes located?

Answer 35

near the elbow and within the axilla

Question 36

What does the left subclavian duct join after it leaves the axillary lymph nodes?

Answer 36

the thoracic duct

Question 37

What does the right subclavian duct joint after it leaves the axillary lymph nodes?

Answer 37

the right lymphatic duct

Question 38

What provides motor innervation to the upper limb?

Answer 38

brachial plexus - ventral rami of spinal nerves of C5 to T1

Question 39

What provides sensory innervation to the upper limb?

Answer 39

fibers from 3 distinct regions (cord levels C4-T3)

• cervical plexus
• brachial plexus
• intercostal nerves

Question 40

How is sensory innervation distributed?

Answer 40

radially - surface of limb ‘steals’ cutaneous distribution from the trunk

Question 41

How is motor innervation distributed?

Answer 41

longitudinally - grows into trunk from above downward