Organization of Upper Limb

Question 1

Organization of Upper Limb Considerations

Answer 1

1. One osseous articulation of scapula to thorax via clavicle allows for flexibility
2. Place burden of stability on sterno-clavicular joint and integrity of muscles that attach scapula to thorax

Question 2

Ball and Socket Joint

Answer 2

1. Reaching above the head or for swinging while supporting body
2. Pulling objects toward the body or pushing objects away from body in all planes

Question 3

Hinge Joint at Elbow

Answer 3

allows us to bring objects closer to trunk and face

Question 4

Pivot Joints of Radius with Ulna

Answer 4

Pronation and supination that allows us to examine objects when grasped

Question 5

Bones of wrist and hand

Answer 5

allow for greater flexibility during grasping, pushing off or for support

Question 6

Joints of fingers

Answer 6

allows for precision manipulation of objects

Question 7

Superficial Fascia of upper limb

Answer 7

Same distribution as rest of body; near cutaneous layer

Question 8

Deep Fascia of upper limb

Answer 8

1. Continuation of muscular fascia of trap, scapular muscles, lat, and pectoral muscles
2. Attaches to boney prominences:
   acromion
   clavicle
   supracondylar lines
   humeral epicondyles
   olecranon process
   interosseous crests of radius and ulna
   tuberosities of carpal bones (flexor retinaculum)
   distal portional of all proximal phalanges

Question 9

Regional names for deep fascia of upper limb

Answer 9

brachial, antebrachial, palmar, thenar and hypothenar

Question 10

Function of deep fascia of upper limb

Answer 10

Forms inter muscular septa 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
(Notes: increases in thickness form proximal to distal)

Question 11

Compartments of deep fascia of upper limb

Answer 11

flexor and extensor compartments

Hand into thenar, hypothenar, central, and adductor-interosseous compartments

Question 12

Deep fascia and transitional zones of upper limb

Answer 12

Responsible for formation and wrapping of transitional zones between regionl subdivisions of the upper limb
axilla
cubital fossa
carpal tunnel
palmar surfaces

Question 13

Axilla

Answer 13

• Transitional space between root of neck and upper limb
• Tetrahedral space bounded by body wall, pectoral, and scapular musculature, humerus and axillary fascia
• conducts vessels, nerves, and lymphatics to and from neck and upper limb

Question 14

Cubital Fossa

Answer 14

• Transitional zone between brachium and forearm
• Triangular space founded by arm and forearm muscles and covered by deep fascia
• contain bifurcation of brachial artery into radial and ulnar artery, the tendon of biceps, and the median nerve

Question 15

Carpal Tunnel

Answer 15

• transitional zones between forearm and hand
• tunnel formed by carpal bones and flexor retinaculum
• transmits median nerve and tendons of the muscles of the forearm which act on fingers

Question 16

Arterial Scheme of upper limb

Answer 16

• subclavian- major artery that provides upper limb
• subclavian changes name as pass through region
• arteries travel within areas surrounded by deep fascia, parallel to bones of the upper limb
• collateral arteries from main branch anastomose to circumvent compression from natural movement

Question 17

Deep venous drainage of upper limb

Answer 17

• deep veins are named for arteries which they travel with

- distally in forearm: veins doubled (located laterally and medial to artery that they travel with

Question 18

Superficial venous drainage of upper limb

Answer 18

• veins are specifically named

- join deep veins as they course centrally

Question 19

Venous structure of upper limb

Answer 19

• have valves that prevent blood from coursing backward

Question 20

Lymphatics of upper limb

Answer 20

• two sets of lymphatics: superficial and deep
• superficial and deep drainage meet at the lymph nodes within axilla
• lymph nodes located near elbow and within axilla

Question 21

Superficial lymph nodes of upper limb

Answer 21

located within skin of upper limb

Question 22

Deep lymph nodes of upper limb

Answer 22

drain muscles and joints that parallel arteries

Question 23

Subclavian duct

Answer 23

• parallels subclavian artery
• leaves axillary lymph nodes and joins thoracic duct on left and right lymphatic duct on right side of body
• ducts join at jugulo-venous angles and return lymph to venous system

Question 24

Jugulo-venous angle

Answer 24

return lymph to venous circulation

Question 25

Motor innervation of upper limb

Answer 25

- provided by brachial plexus - composed of ventral rami of C5-T1 via brachial plexuss - 5 terminal branches innervate muscles within upper limb - proximal branches innervate muscles that attach the scapula to upper limb and trunk - specific compartmental innervation= contains characteristic nerve lesions that have symptoms specific to nerve loss * **distributed longitudinally (embryology development)

Question 26

Sensory innervation of upper limb

Answer 26

``` -fibers from 3 distinct origins cervical plexus brachial plexus intercostal nerves C4-T3 **distributed radially (embryology development) ```