Osteology and circulation of the upper limb Flashcards
1
Q
Name and point to all of the different bones in the upper limb?
A
Clavicle, Scapula, Humerus, Radius, Ulna, Carpus, Metacarpus, Phalanges
2
Q
What is significant about the clavicles surfaces?
A
Its superior side is smooth and the inferior is rough due to tendons and muscles attaching there
3
Q
How can the Medial and Lateral ends of the clavicle be described?
A
Medial - round
Lateral - flat
4
Q
What are the names of the proximal/medial and distal/lateral ends of the clavicles?
A
Medial - Sternal end
Lateral - Acromial end
5
Q
What is the name of the bump on the inferior surface near the lateral end of the clavicle?
A
Conoid tubercle
6
Q
What is the facet on the lateral end of the clavicle called?
A
Acromial facet
7
Q
What is the name of the line on the clavicle found between the conoid tubercle and the acromial facet?
A
The trapezoid line
8
Q
What is the groove that runs inferiorly in the middle of the clavicle called?
A
The subclavian groove
9
Q
What is the facet on the medial end of the clavicle called?
A
Sternal facet
10
Q
What does the impression inferior close to the medial end of the clavicle hold?
A
The costoclavicular ligament
11
Q
What is the only boney connection from the upper limbs to the axial skeleton?
A
Clavicle
12
Q
If I fell with my arms straight out what bone am I likely to break?
A
Clavicle as force is transmitted through arm to clavicle
13
Q
What are the 3 features of the sternoclavicular joint?
A
Very strong ligaments
Fibrocartilage lined joint
Articular disc
14
Q
What are the 3 angles of the Scapula?
A
Superior
Inferior
Lateral
15
Q
What are the 3 Fossae of the Scapula?
A
Supraspinous
Infraspinous
Subscapular
16
Q
What are the 3 borders of the Scapula ?
A
Medial
Lateral
Superior
17
Q
What ligament attaches above the suprascapular notch and what does this form ?
A
Upper transverse Scapular ligament which forms the Suprascapular foramen
18
Q
What runs through the Suprascapular foramen?
A
Suprascapular nerve
19
Q
How many tubercles does the humerus have and what are their names?
A
2: Greater and lesser tubercle
20
Q
What are the 2 necks found on a humerus ?
A
Anatomical neck
Surgical neck
21
Q
What are the lumps, bumps and lines for in the humerus ?
A
Muscle attachment
22
Q
What do the ligaments in the Glenohumeral joint do?
A
Thicken the joint capsule
23
Q
What are the 3 Glenohumeral joint ligaments?
A
Superior
Middle
Inferior
24
Q
What are the 3 other Glenohumeral ligaments?
A
Coraco-humeral ligament
Transverse humeral ligament
Long head of biceps
25
What muscles are found in the Glenohumeral joint?
Rotator cuff muscles
26
What is the function of the rotator cuff?
Stabilises the Glenohumeral joint - This is why muscle tone of this is important in preventing dislocation
27
What are the 4 Bursae in the Glenohumeral joint?
Subacromial (Subdeltoid - SASD)
Subscapular
Subcoracoid
Coracobrachial
28
What are the 2 tubercles found in the Humerus ?
Inter-tubercle sulcus
| Medial lateral lips
29
What are the 3 different types of Humeral fractures, where are they found and what nerves are affected?
Mid shaft - Spiral groove in humerus (starts superiorly) - Radial Nerve
Surgical neck - Middle of Humerus - Auxillary nerve
Supracodylar - Above elbow joint - Median nerves
30
What Humeral fracture is most common and what is this caused by?
Surgical fracture due to people falling on arm
31
What attaches to the supinator crest?
Supinator muscle
32
What keeps the elbow capsule lax both anteriorly and posteriorly?
The collateral ligaments
33
What ligament is affected if someone has "pulled elbow" or "Nurse maid" elbow?
The annular ligament
34
What movement does the annular ligament of the radius allow for?
Allows the radius to do supination and pronation
35
What is the special relationship between bursae and muscles?
Bursae are named after the muscles they are related to
36
What is a Colles fracture?
Fracture of distal radius - common in old ladies with hands stretched out when falling
37
What kind of deformity appears in those with a Colles fracture?
Dinner fork deformity
38
What type of joint is the Middle Radio-Ulnar joint?
Syndesmosis - fibrous joint
39
What prevents the radius and ulnar from separating ?
The interosseous membrane
40
What bone in the forearm does all of the movement?
Radius - it moves around Ulnar
41
What are the 3 features of the distal radio-ulnar joint?
1) . Has a fibrous disc
2) . Has anterior and posterior radio-ulnar ligaments (weak)
3) . Synovial membrane
42
What does the Sacciform Recess do ?
Aid movement
43
How many hand bones is there?
27
44
How many Phalanges is there?
14 - long bones (3 in each digit and 2 in thumb)
45
How many metacarpals is there?
5 - long bones (1 for each digit and thumb)
46
How many Carpal bones is there?
8 - short bones
47
What are sesamoid bones?
a Sesamoid bone is a bone embedded in a tendon
48
What are the 4 proximal carpal bones from medial to lateral (in anatomical position!) ?
Scaphoid
Lunate
Triquetrum
Pisform
49
What are the 4 distal bones from medial to lateral (in anatomical position!) ?
Trapezium
Trapezoid
Capitate
Hammate
50
What is the acronym for remembering Carpal bones?
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51
What isn't involved in the wrist joint and why
The ulna - as it is separated from the wrist by a fibrocartilage disc
52
What are the 2 radio-carpal ligaments?
Palmar and dorsal radio-carpal ligaments
53
Where is the ulno-carpal ligament?
The palmer ulno-carpal ligament
54
What is significant about the radial and ulnar ligaments?
They run co-laterally
55
What kind of joints are inter carpal joints?
plane joints - sliding movement
56
Where are mid carpal joints and what are their function?
Between rows - abduction/extension
57
What kind of joint is between the pisoform and triquetrum?
Pisoiotriquetral joint
58
What kind of joints occur between the 5 metacarpal joints?
1st metacarpal joint - saddle joint
| 2nd- 5th metacarpal joint - condyloid joints (allows movement in 2 planes (like a ball joint)
59
What is the carpal joint capsule continuous with and what can this cause?
Continuous with Carpal-metacarpal - spread of infection
60
What is the carpal tunnel formed by ?
Carpal bones form a carpal arch
(Medially - Hook of Hamate and Pisoform)
(Laterally - Tubercle of Trapezium and Scaphoid)
Flexor retinaculum forms a roof
61
What ligament runs in the Metacarpal phalangeal joint?
Collateral and palmar ligaments
62
What ligament runs in the interphalangeal joints?
Collateral and palmar ligaments
63
What kind of joints are interphalangeal joints?
Hinge joints
64
What kind of movements can interphalangeal joints do?
Flexion and extension
65
What kind of movements can metacarpal-phalangeal joints do?
Flexion, Extension, Adduction, Abduction
(Middle finger can only abduct and flex, no adduction as middle finger is set reference point for other fingers to adduct to)
66
Where do the Subclavian arteries begin?
Right subclavian begins at the brachiocephalic trunk which extends out from the arch of aorta
Left subclavian begins at the arch of aorta
67
Where do the subclavian arteries end and what do they become next?
Subclavian arteries end at the lateral border of the 1st rib then becomes the axillary artery
68
What 2 other arteries does the subclavian artery branch of into?
The dorsal scapular and suprascapular arteries
69
What route does the subclavian arteries take?
Pass behind the clavicle over the top of the rib
70
Where does the axillary artery run from and to?
The lateral border of the 1st rib, crossing posteriorly to pectoralis minor to the inferior border of Teres major
71
What does the axillary artery become after?
The brachial artery
72
What is used as a landmark to split the axillary into the sections and where are these 3 sections found and what do they have?
Pectoralis minor
First Part (Proximal to Pectoralis Minor): This part gives off one branch, which is the superior thoracic artery.
Second Part (Behind Pectoralis Minor): This part usually gives off two branches, which are the thoracoacromial artery and the lateral thoracic artery.
Third Part (Distal to Pectoralis Minor): This part typically gives off three branches, which are the subscapular artery, anterior circumflex humeral artery, and posterior circumflex humeral artery.
73
What does the Scapular anastomosis do?
Connects the subclavian to the axillary artery
74
Where does the brachial artery start and end?
Starts at the lower border or Teres major and ends at its bifurcation anterior to the elbow before splitting into the ulnar and radial arteries
75
What are the 3 different branches of the Brachial artery ?
Profunda barachii (runs laterally down back)
Superior Ulnar collateral
Inferior Ulnar collateral
76
What are 3 features of radial and ulnar arteries?
Variable bifurcation
Ulnar is larger and deeper than radial
Both have recurrent branches -> Elbow anastomosis
77
What is the journey of the radial artery in the arm?
The radial artery lies anterior in the forearm then dorsally at the wrist before forming the anatomical snuffbox
78
What is the journey of the ulnar artery in the arm?
The ulnar artery remains anterior into the hand
79
What does the Ulnar artery quickly branch off into?
Common interosseous arteries then Anterior and posterior interosseous arteries
80
What arteries are palatable at the wrist?
The radial (stronger) and ulnar (weaker) arteries
81
What happens to the radial and ulnar arteries at the wrist?
Neither enter the carpal tunnel
Radial passes posteriorly to carpal bones
Ulnar passes anteriorly (superficially) to the flexor retinaculum
82
What is inside Guyons canal?
Ulnar nerve and artery
83
What is Allens test?
Patients clench both fists for 1 min
Pressure is applied to the Ulnar and radial arteries
Still elevated the hand should appear blanched
Ulnar is released and colour should return in 5-15 seconds
Should be repeated with Radial artery after
Shows a good collateral blood supply to wrist
84
What branches does the radius and ulnar arteries have at the wrist?
Palmar and dorsal carpal branches and dorsal and palmar carpal arches
85
What can a Scaphoid fracture cause?
Avascular necrosis
86
What is the journey of the superficial arteries of the hand?
- The ulnar artery enters the hand and gives off a deep branch
- This continues as a superficial ulnar branch, creating the superficial palmar arch
- This then meets the superficial palmar arch of the radial artery branch
- This arch gives of 3 common palmar digital arteries
- Each of the 3 common palmar digital arteries split off into 2 proper palmar digital arteries which pass up either side of each finger
87
What is the journey of the deep arteries of the hand?
- The radial artery passes posteriorly on the scaphoid and trapezium
- The radial artery then re-enters the palmar surface through the 1st dorsal interosseous muscles to the princeps policis artery
- This then forms deep palmar arch (anastomosing with deep branches of ulnar artery)
- The deep palmar arch gives off palmar metacarpal arteries which anastomose with common palmar arteries
88
What does hand Anastomoses do?
Provide a good collateral supply around highly moveable joints
Hand arterioles are very important for thermoregulation
89
What do most veins follow and what are these specific veins called?
Most veins follow arterial supply - Known as Venae comitantes
90
What do brachial veins come together to form?
Axillary Veins
91
What else attaches onto the Axillary veins and where can this be found?
Basilic vein at the lower border of Teres Major
92
What is the network of veins on the back of the hand called and what does this give rise to?
Dorsal venus network (Arch) - gives Cephalic and Basilic veins
93
What do the veins in the axilla often do?
Anastomose
94
What else joins onto the Axillary vein?
Body wall veins from lower abdomen
95
What are the 5 Axillary lymph nodes?
Humeral, central, apical, subscapular and pectoral
96
What makes up the pectoral girdle ?
The pectoral girdle is outlined by the upper border of one scapula, the clavicle, upper border of the sternum, the collateral clavicle and scapula
97
What does the sternoclavicular joint attach?
There sternoclavicular joint attaches the superior appendicular skeleton to the axial skeleton
98
Where does the medial articular facet of the clavicle articulate with?
The manubrium of the sternum
99
Where does the lateral articular facet of the clavicle articulate with?
The Acromion of the Scapula
100
What attaches to the subclavian groove?
The subclavius muscle and clavipectroal fascia
101
What attaches to the trapezoid ligament?
The trapezoid ligament
102
What is the joint where the clavicle articulates with the acromion of the scapula called?
The acromioclavicular joint
103
What does the Conoid ligament and Trapezoid ligament form together?
The coracoclavicular ligament
104
Where are forces from the upper limb transmitted to?
Forces from the upper limb are transmitted by the trapezius to the cervical spine and by the clavicle to the axial skeleton by the coracoclavicular and costoclavicular ligaments
105
What attaches to the lateral border of the Scapula?
Heres major and minor
106
What attaches to the medial border of the Scapula ?
Rhomboid muscles
107
What ribs are the superior and inferior angles at the level of?
Superior angle - At level of 2nd rib
Inferior angle - At level of 7th rib
108
What muscles attach to the Acromion ?
The posterior fibres of the deltoid muscle and middle fibres of the trapezius
109
What muscles attach to the Corcoid process?
The short head of biceps, coracobrachialis and pectorals minor muscles
110
What attaches to the supraglenoid process?
The origin of the tendon of the long head of biceps muscle
111
What attaches to the infraglenoid process?
The origin of the tendon of the long head of triceps
112
What muscle attaches to the lesser tubercle of the humerus?
The subscapularis muscle
113
What muscles attach to the greater tubercle of the humerus?
Upper part of tubercle - supraspinatus, infraspinatus and teres minor muscle
114
What tendon is found in the intertubecular sulcus (bicipital groove) ?
The long tendon of the biceps muscle
115
What muscles attach to the medial and lateral lips ?
Medial lip - Teres major
Lateral lip - Pectoralis major
116
What muscle attaches in the groove between the 2 lips on the humerus ?
The latissimus dorsi
117
What muscle attaches to the deltoid tuberosity ?
The deltoid
118
What bone articulates with the Capitulum?
The radius
119
What bone articulates with the Trochlea?
The ulnar
120
What is held in the groove that runs inferior and posterior to the medial epicondyle ?
The groove for the ulnar nerve
121
What is the surface of the radius which articulates with the ulnar called?
The Circumferential surface
122
What tendon attaches to the radial tuberosity ?
The distal tendon of the biceps muscle
123
What is the name of the roughened area near the midpoint of the midpoint of the lateral surface of the radial shaft?
The pronator tuberosity
124
What tendons attach to the several grooves in the dorsal tubercle ?
Tendons of forearm muscles
125
What muscle attaches to the Olecranon ?
The distal attachment of the triceps muscle
126
What muscle attaches to the coronoid process in the ulnar ?
The brachialis
127
What articulates at the radial notch?
The head of the radius and the ulna
128
What muscle attaches attaches at the supinator crest and fossa?
The supinator muscle
129
What is located just inferior to the radial notch on the ulnar?
The supinator crest
130
What is the distal end of the ulna called?
The head of the ulna
131
What tendon passes in the groove that runs between the styloid process and the ulnar head ?
A tendon of the extensor muscle of the forearm
