Organization of the upper limb

Question 1

where is the singular osseous articulation of the upper limb?

Answer 1

sternoclavicular joint

helps with tremendous flexibility of the upper limb

Question 2

what kind of joint is at the shoulder and what does it allow for?

Answer 2

ball and socket joint

allows for

• reaching above the head or for swinging while supporting the body
• pulling objects towards the body or pushing objects away from the body IN ALL PLANES

Question 3

what kind of joint is at the elbow and what does it allow us to do?

Answer 3

hinge joint

allows us to bring objects closer to the trunk and face

Question 4

what type of joints are the radius and ulna and what do they allow?

Answer 4

pivot joints

allow for pronation and supination that allow us to examine objects when grasped

Question 5

what do the multiple bones of the wrist or hand allow for ?

Answer 5

greater flexibility during grasping, pushing-off or for support

Question 6

what do the multiple joints of the fingers allow?

Answer 6

precision and manipulation of objects

Question 7

what is deep fascia a continuation of and what does it attach to?

Answer 7

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

attaches to bony prominences that are not covered by muscle (acromion for example)

Question 8

where does the fascia form stuff?

Answer 8

intermuscular septae in the arm and forearm

interosseous membrane in the ante brachium

palmar carpal ligament of the distal flexor forearm

flexor and extensor retinaculum of the carpus

palmar aponeurosis of the hand

Question 9

axilla

Answer 9

transitional space between the root of the neck and the upper limb

Question 10

cubital fossa

Answer 10

transitional zone between brachium and the forearm

Question 11

what covers the cubital fossa?

Answer 11

deep fascia

Question 12

what is in the cubital fossa?

Answer 12

Artery— contains the bifurcation of the brachial artery into the radial and ulnar arteries

T— tendon of the biceps

N—- median neve

lateral TAN medial

Question 13

carpal tunnel

Answer 13

transitional zone between between the forearm and hand

Question 14

what forms the tunnel of the carpal tunnel

Answer 14

carpal bones and flexor retinaculum

Question 15

what goes through carpal tunnel

Answer 15

median nerve

tendons of the muscles of the forearm which act on the fingers

Question 16

what is the major artery of the upper limb?

Answer 16

subclavian

Question 17

what are anastomotic branches and where are they in the upper limb

Answer 17

these are branches that provide a collateral means of circumventing compression that occurs during normal movement (bending of the elbow)

located at each major jointed area

Question 18

how do arteries travel?

Answer 18

travel within areas surrounded by deep fascia

parallel to bones of the upper limb for protection

Question 19

how are deep veins named? how are they organized in the distally in the forearm

Answer 19

for the arteries with which they travel

in the forearm they are usually doubled, located lateral and medial to the artery with which they travel

Question 20

what is the function of valves in the limbs?

Answer 20

due to lack of venous pressure or increased venous resistance, these prevent blood from coursing in the opposite direction

Question 21

lymphatics in the limb

Answer 21

two sets -

• superficial –> located in skin
• deep–> draining the muscles and joints that parallels arteries

Question 22

where are lymph nodes in the upper limb?

Answer 22

elbow and axilla

this is where both the superficial and deep lymphatics meet and drain

Question 23

what and where is the subclavian duct

Answer 23

lymphatic duct parallleling the subclavian artery

leaves the axillary lymph nodes to join the thoracic duct on the left or the right lymphatic duct on the right side

both ducts then join jugulo-venous angles (junction of the internal jugular vein with the subclavian v.)
RETURNING LYMPH TO THE VENOUS CIRCULATION so bad if cancer gets here

Question 24

what provides motor innervation to the upper limb

Answer 24

brachial plexus composed of VENTRAL RAMI of spinal nerves C5-T1

the five terminal branches innervate muscles located within the upper limb

compartmental innervation is very specific

Question 25

sensory innervation of upper limb

Answer 25

provided by fibers derived from three distinct origins:

• cervical plexus
• brachial plexus
• intercostal nerves

representing spinal cords levels C4-T3

Question 26

How is sensory innervation to the upper limb distributed?

Answer 26

radially (in anatomical position)

Question 27

how is motor innervation to the upper limb distributed?

Answer 27

longitudinally

Question 28

why is the difference between how motor and sensory innervation is organized important?

Answer 28

important in diagnosing spinal cord levels of injury in response to paralysis and paresthesias