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MD2002 Lucas > Osteology and circulation of the upper limb > Flashcards

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

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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

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3
Q

How can the Medial and Lateral ends of the clavicle be described?

A

Medial - round

Lateral - flat

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4
Q

What are the names of the proximal/medial and distal/lateral ends of the clavicles?

A

Medial - Sternal end

Lateral - Acromial end

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5
Q

What is the name of the bump on the inferior surface near the lateral end of the clavicle?

A

Conoid tubercle

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6
Q

What is the facet on the lateral end of the clavicle called?

A

Acromial facet

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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

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8
Q

What is the groove that runs inferiorly in the middle of the clavicle called?

A

The subclavian groove

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9
Q

What is the facet on the medial end of the clavicle called?

A

Sternal facet

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10
Q

What does the impression inferior close to the medial end of the clavicle hold?

A

The costoclavicular ligament

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11
Q

What is the only boney connection from the upper limbs to the axial skeleton?

A

Clavicle

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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

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13
Q

What are the 3 features of the sternoclavicular joint?

A

Very strong ligaments
Fibrocartilage lined joint
Articular disc

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14
Q

What are the 3 angles of the Scapula?

A

Superior
Inferior
Lateral

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15
Q

What are the 3 Fossae of the Scapula?

A

Supraspinous
Infraspinous
Subscapular

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16
Q

What are the 3 borders of the Scapula ?

A

Medial
Lateral
Superior

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17
Q

What ligament attaches above the suprascapular notch and what does this form ?

A

Upper transverse Scapular ligament which forms the Suprascapular foramen

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18
Q

What runs through the Suprascapular foramen?

A

Neurovascular bundles

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19
Q

How many tubercles does the humerus have and what are their names?

A

2: Greater and lesser tubercle

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20
Q

What are the 2 necks found on a humerus ?

A

Anatomical neck

Surgical neck

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21
Q

What are the lumps, bumps and lines for in the humerus ?

A

Muscle attachment

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22
Q

What do the ligaments in the Glenohumeral joint do?

A

Thicken the joint capsule

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23
Q

What are the 6 ligaments involved in stabilising the glenohumeral joint?

A

Superior glenohumeral ligament
Middle glenohumeral ligament
Inferior glenohumeral ligament
Coraco-acromial ligament
Coraco-humeral ligament
Transverse humeral ligament

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24
Q

What is the muscle that supports the glenohumeral joint? (other than rotator cuff muscles)

A

The long head of biceps brachii passes up into the joint capsule and attaches over the top of the humeral head, which helps to prevent humeral dislocation

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25
Q

What muscles are found in the Glenohumeral joint?

A

Rotator cuff muscles:
Supraspinatus
Infraspinatus
Subscapularis
Teres minor

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26
Q

What is the function of the rotator cuff?

A

Stabilises the Glenohumeral joint - This is why muscle tone of this is important in preventing dislocation

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27
Q

What are the 4 Bursae in the Glenohumeral joint?

A

Subacromial (Subdeltoid - SASD)
Subscapular
Subcoracoid
Coracobrachial

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28
Q

What are the 2 tubercles found in the Humerus? And what is in between?

A

Lesser and greater tubercle

Intertubercular groove

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29
Q

What are the 3 different types of Humeral fractures, where are they found and what nerves are affected?

A

Mid shaft - Spiral groove in humerus (starts superiorly) - Radial Nerve
Surgical neck - Middle of Humerus - Auxillary nerve
Supracodylar - Above elbow joint - Median nerves

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30
Q

What Humeral fracture is most common and what is this caused by?

A

Surgical fracture due to people falling on arm

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31
Q

What attaches to the supinator crest?

A

Supinator muscle

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32
Q

What keeps the elbow capsule lax both anteriorly and posteriorly?

A

The collateral ligaments

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33
Q

What ligament is affected if someone has “pulled elbow” or “Nurse maid” elbow?

A

The annular ligament

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34
Q

What movement does the annular ligament of the radius allow for?

A

Allows the radius to do supination and pronation

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35
Q

What is the special relationship between bursae and muscles?

A

Bursae are named after the muscles they are related to

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36
Q

What is a Colles fracture?

A

Fracture of distal radius - common in old ladies with hands stretched out when falling

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37
Q

What kind of deformity appears in those with a Colles fracture?

A

Dinner fork deformity

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38
Q

What type of joint is the Middle Radio-Ulnar joint?

A

Syndesmosis - fibrous joint

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39
Q

What prevents the radius and ulnar from separating ?

A

The interosseous membrane

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40
Q

What bone in the forearm does all of the movement?

A

Radius - it moves around Ulnar

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41
Q

What are the 3 features of the distal radio-ulnar joint?

A

1) . Has a fibrous disc
2) . Has anterior and posterior radio-ulnar ligaments (weak)
3) . Synovial membrane

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42
Q

What does the Sacciform Recess do ?

A

Aid movement

The sacciform recess is a thin extension of the articular capsule of the

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43
Q

How many hand bones is there?

A

27

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44
Q

How many Phalanges is there?

A

14 - long bones (3 in each digit and 2 in thumb)

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45
Q

How many metacarpals is there?

A

5 - long bones (1 for each digit and thumb)

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46
Q

How many Carpal bones is there?

A

8 - short bones

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47
Q

What are sesamoid bones?

A

a Sesamoid bone is a bone embedded in a tendon

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48
Q

What are the 4 proximal carpal bones from medial to lateral (in anatomical position!) ?

A

Scaphoid
Lunate
Triquetrum
Pisform

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49
Q

What are the 4 distal carpal bones from medial to lateral (in anatomical position!) ?

A

Trapezium
Trapezoid
Capitate
Hammate

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50
Q

What is the acronym for remembering Carpal bones?

A

Some
Lovers
Try
Positions
That
They
Cant
Handle

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51
Q

What isn’t involved in the wrist joint and why

A

The ulna - as it is separated from the wrist by a fibrocartilage disc

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52
Q

What are the 2 radio-carpal ligaments?

A

Palmar and dorsal radio-carpal ligaments

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53
Q

Where is the ulno-carpal ligament?

A

The palmer ulno-carpal ligament

54
Q

What is significant about the radial and ulnar ligaments?

A

They run co-laterally

55
Q

What kind of joints are inter carpal joints?

A

plane joints - sliding movement

56
Q

Where are mid carpal joints and what are their function?

A

Between rows - abduction/extension

57
Q

What name of joint is between the pisoform and triquetrum?

A

Pisoiotriquetral joint

58
Q

What kind of joints occur between the 5 carpometacarpal joints?

A

1st carpometacarpal joint - saddle joint
2nd- 5th carpometacarpal joint - condyloid joints (allows movement in 2

59
Q

What is the carpal joint capsule continuous with and what can this cause?

A

Continuous with Carpal-metacarpal - spread of infection

60
Q

What is the carpal tunnel formed by ?

A

Carpal bones form a carpal arch
(Medially - Hook of Hamate and Pisoform)
(Laterally - Tubercle of Trapezium and Scaphoid)

Flexor retinaculum forms a roof

61
Q

What ligament runs in the Metacarpal phalangeal joint?

A

Collateral and palmar ligaments

62
Q

What ligament runs in the interphalangeal joints?

A

Collateral and palmar ligaments

63
Q

What kind of joints are interphalangeal joints?

A

Hinge joints

64
Q

What kind of movements can interphalangeal joints do?

A

Flexion and extension

65
Q

What kind of movements can metacarpal-phalangeal joints do?

A

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
Q

Where do the Subclavian arteries begin?

A

Right subclavian begins at the brachiocephalic trunk which extends out from the arch of aorta

Left subclavian begins at the arch of aorta

67
Q

Where do the subclavian arteries end and what do they become next?

A

Subclavian arteries end at the lateral border of the 1st rib then becomes the axillary artery

68
Q

What 2 other arteries does the subclavian artery branch of into?

A

The dorsal scapular and suprascapular arteries

69
Q

What route does the subclavian arteries take?

A

Pass behind the clavicle over the top of the rib

70
Q

Where does the axillary artery run from and to?

A

The lateral border of the 1st rib, crossing posteriorly to pectoralis minor to the inferior border of Teres major

71
Q

What does the axillary artery become after?

A

The brachial artery

72
Q

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?

A

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
Q

What does the Scapular anastomosis do?

A

Connects the subclavian to the axillary artery

74
Q

Where does the brachial artery start and end?

A

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
Q

What are the 3 different branches of the Brachial artery ?

A

Profunda barachii (runs laterally down back)
Superior Ulnar collateral
Inferior Ulnar collateral

76
Q

What are 3 features of radial and ulnar arteries?

A

Variable bifurcation
Ulnar is larger and deeper than radial
Both have recurrent branches -> Elbow anastomosis

77
Q

What is the journey of the radial artery in the arm?

A

The radial artery lies anterior in the forearm then dorsally at the wrist before forming the anatomical snuffbox

78
Q

What is the journey of the ulnar artery in the arm?

A

The ulnar artery remains anterior into the hand

79
Q

What does the Ulnar artery quickly branch off into?

A

Common interosseous arteries then Anterior and posterior interosseous arteries

80
Q

What arteries are palatable at the wrist?

A

The radial (stronger) and ulnar (weaker) arteries

81
Q

What happens to the radial and ulnar arteries at the wrist?

A

Neither enter the carpal tunnel

Radial passes posteriorly to carpal bones

Ulnar passes anteriorly (superficially) to the flexor retinaculum

82
Q

What is inside Guyons canal?

A

Ulnar nerve and artery

83
Q

What is Allens test?

A

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
Q

What branches does the radius and ulnar arteries have at the wrist?

A

Palmar and dorsal carpal branches and dorsal and palmar carpal arches

85
Q

What can a Scaphoid fracture cause?

A

Avascular necrosis

86
Q

What is the journey of the superficial arteries of the hand?

A
  • 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
Q

What is the journey of the deep arteries of the hand?

A
  • 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
Q

What does hand Anastomoses do?

A

Provide a good collateral supply around highly moveable joints

Hand arterioles are very important for thermoregulation

89
Q

What do most veins follow and what are these specific veins called?

A

Most veins follow arterial supply - Known as Venae comitantes

90
Q

What do brachial veins come together to form?

A

Axillary Veins

91
Q

What else attaches onto the Axillary veins and where can this be found?

A

Basilic vein at the lower border of Teres Major

92
Q

What is the network of veins on the back of the hand called and what does this give rise to?

A

Dorsal venus network (Arch) - gives Cephalic and Basilic veins

93
Q

What do the veins in the axilla often do?

A

Anastomose

94
Q

What else joins onto the Axillary vein?

A

Body wall veins from lower abdomen

95
Q

What are the 5 Axillary lymph nodes?

A

Humeral, central, apical, subscapular and pectoral

96
Q

What makes up the pectoral girdle ?

A

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
Q

What does the sternoclavicular joint attach?

A

There sternoclavicular joint attaches the superior appendicular skeleton to the axial skeleton

98
Q

Where does the medial articular facet of the clavicle articulate with?

A

The manubrium of the sternum

99
Q

Where does the lateral articular facet of the clavicle articulate with?

A

The Acromion of the Scapula

100
Q

What attaches to the subclavian groove?

A

The subclavius muscle and clavipectroal fascia

101
Q

What attaches to the trapezoid line?

A

The trapezoid ligament

102
Q

What is the joint where the clavicle articulates with the acromion of the scapula called?

A

The acromioclavicular joint

103
Q

What does the Conoid ligament and Trapezoid ligament form together?

A

The coracoclavicular ligament

104
Q

Where are forces from the upper limb transmitted to?

A

Forces from the upper limb are transmitted bu the trapezius to the cervical spine and by the clavicle to the axial skeleton by the coracoclavicular and costoclavicular ligaments

105
Q

What attaches to the lateral border of the Scapula?

A

Heres major and minor

106
Q

What attaches to the medial border of the Scapula ?

A

Rhomboid muscles

107
Q

What ribs are the superior and inferior angles at the level of?

A

Superior angle - At level of 2nd rib

Inferior angle - At level of 7th rib

108
Q

What muscles attach to the Acromion ?

A

The posterior fibres of the deltoid muscle and middle fibres of the trapezius

109
Q

What muscles attach to the Corcoid process?

A

The short head of biceps, coracobrachialis and pectorals minor muscles

110
Q

What attaches to the supraglenoid process?

A

The origin of the tendon of the long head of biceps muscle

111
Q

What attaches to the infraglenoid process?

A

The origin of the tendon of the long head of triceps

112
Q

What muscle attaches to the lesser tubercle of the humerus?

A

The subscapularis muscle

113
Q

What muscles attach to the greater tubercle of the humerus?

A

Upper part of tubercle - supraspinatus, infraspinatus and teres minor muscle

114
Q

What tendon is found in the intertubecular sulcus (bicipital groove) ?

A

The long tendon of the biceps muscle

115
Q

What muscles attach to the medial and lateral lips ?

A

Medial lip - Teres major

Lateral lip - Pectoralis major

116
Q

What muscle attaches in the groove between the 2 lips on the humerus ?

A

The latissimus dorsi

117
Q

What muscle attaches to the deltoid tuberosity ?

A

The deltoid

118
Q

What bone articulates with the Capitulum?

A

The radius

119
Q

What bone articulates with the Trochlea?

A

The ulnar

120
Q

What is held in the groove that runs inferior and posterior to the medial epicondyle ?

A

The groove for the ulnar nerve

121
Q

What is the surface of the radius which articulates with the ulnar called?

A

The Circumferential surface

122
Q

What tendon attaches to the radial tuberosity ?

A

The distal tendon of the biceps muscle

123
Q

What is the name of the roughened area near the midpoint of the midpoint of the lateral surface of the radial shaft?

A

The pronator tuberosity

124
Q

What tendons attach to the several grooves in the dorsal tubercle ?

A

Tendons of forearm muscles

125
Q

What muscle attaches to the Olecranon ?

A

The distal attachment of the triceps muscle

126
Q

What muscle attaches to the coronoid process in the ulnar ?

A

The brachialis

127
Q

What articulates at the radial notch?

A

The head of the radius and the ulna

128
Q

What muscle attaches attaches at the supinator crest and fossa?

A

The supinator muscle

129
Q

What is located just inferior to the radial notch on the ulnar?

A

The supinator crest

130
Q

What is the distal end of the ulna called?

A

The head of the ulna

131
Q

What tendon passes in the groove that runs between the styloid process and the ulnar head ?

A

A tendon of the extensor muscle of the forearm

MD2002 Lucas (111 decks)

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