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Anatomy Exam 3 > Overview of Upper Extremity > Flashcards

Overview of Upper Extremity Flashcards

1
Q

What are the Divisions of the Upper Extremity

A
  • Pectoral Girdle/Shoulder
  • Axilla (Armpit)
  • Arm (Brachium): between shoulder and elbow
  • Cubital fossa: anterior aspect of elbow
  • Forearm (Antebrachium): between elbow and wrist
  • Wrist (Carpus)
  • Hand (palmar and dorsal aspects) (Note: the thumb is lateral and the pinkie is medial)
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2
Q

What is the Osteology of the Upper Extremity

A 
Includes: clavicle, scapula, humerus, ulna (medial bone of forearm), radius (lateral bone of forearm), 
8 carpals (proximal row: scaphoid, lunate, triquetrum, pisiform; distal row: trapezium, trapezoid, capitate, hamate), 
5 metacarpals (proximal part is the base, distal part is the head), 
14 phalanges (proximal, middle, distal; the pollex (thumb) has a proximal and distal phalanx only)
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3
Q

Describe the Clavicle

A
  • S-shaped bone that connects upper extremity to axial skeleton
  • Acts as a strut to hold upper limb in a lateral position
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4
Q

Describe the Scapula borders, angles, processes, and notches.

A

Borders: Superior, Medial, and Lateral Borders

Angles

  • Superior angle (superomedial corner)
  • Inferior angle (inferomedial corner)

Processes

  • Coracoid process (anterior projection)
  • Spine of the scapula (posterior ridge)
  • Acromion process (projection at lateral end of scapular spine)

Suprascapular notch

  • on superior border
  • Superior transverse scapular ligament spans the notch to form a foramen for the passage of the suprascapular nerve
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5
Q

Describe the Scapula fossae

A
  • Supraspinous fossa (posterior surface, superior to spine of scapula)
  • Infraspinous fossa (posterior surface, inferior to spine of scapula)
  • Subscapular fossa (anterior surface, faces ribs)
  • Glenoid cavity (lateral surface, articulates with head of humerus)
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6
Q

Describe the Head, neck, and tubercles of the Humerus

A

Head (articulates with glenoid cavity of scapula)

Tubercles and associated structures

  • Greater tubercle (lateral)
  • Lesser tubercle (anterior)
  • Intertubercular (bicipital) groove: Houses the tendon of the long head of biceps brachii

Necks

  • Anatomical neck between head and tubercles
  • Surgical neck between tubercles and shaft (body)
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7
Q

Describe other features of the Humerus

A
  • Deltoid tuberosity (lateral prominence on proximal humeral shaft)
  • Medial Epicondyle (medial protuberance of distal humerus)
  • Lateral Epicondyle (lateral protuberance of distal humerus)
  • Capitulum (ball shaped structure on distal humerus; articulates with radial head)
  • Trochlea (spool shaped structure on distal humerus; articulates with proximal ulna)
  • Radial groove (on posterior shaft; oblique groove for radial nerve & deep artery of the arm)
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8
Q

Describe the Radius & Ulna

A

Radius (lateral bone of forearm)
-Radial tuberosity (proximal end; anteromedial surface)

Ulna (medial bone of forearm)

  • Olecranon process (most proximal part of bone)
  • Ulnar tuberosity (proximal end; anterior surface)
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9
Q

Describe the Sternoclavicular (SC) Joint

A
  • Synovial joint between the clavicle and the manubrium of sternum
  • Allows the clavicle to move anterior/posterior and superior/inferior
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10
Q

Describe the Acromioclavicular (AC) Joint

A
  • Synovial joint between the clavicle and the acromion of scapula
  • Allows the acromion to rotate on the clavicle
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11
Q

Describe the Scapulothoracic (ST) Joint

A
  • Not a true anatomic joint (no synovial tissue, no osseous connection)
  • It is a functional joint, permitting movement
  • Refers to the movement of the scapula on the thoracic wall
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12
Q

Describe the Movements of the Scapula

A
  • Elevation moves the scapula superiorly
  • Depression moves the scapula inferiorly
  • Retraction draws the scapula posteriorly, such that the medial borders of the two scapulae are drawn together
  • Protraction draws the scapula anteriorly, such that the medial borders of the two scapulae are pulled apart
  • Upward rotation directs the surface of the glenoid cavity superiorly
  • Downward rotation directs the surface of the glenoid cavity inferiorly
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13
Q

Describe the Glenohumeral (GH) Joint

A
  • Head of the humerus articulates with the glenoid cavity of the scapula
  • Ball and socket synovial joint with a wide range of motion
  • Flexion moves the upper extremity (UE) anteriorly
  • Extension moves the UE posteriorly
  • Abduction draws the UE away from the midline of the body
  • Adduction draws the UE towards the midline of the body
  • Medial and lateral rotation-humerus rotates around its long axis
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14
Q

Describe the Scapulohumeral Rhythm

A
  • Movements of the SC, AC, and ST joints are all coordinated with movements of the glenohumeral joint to produce a full range of motion.
  • Every 2 degrees of glenohumeral motion is associated with 1 degree of scapulothoracic movement (occurring as combined actions of the SC, AC, & ST joints).
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15
Q

Describe the Elbow Joint

A
  • Distal humerus articulates with the proximal radius and ulna
  • Hinge synovial joint
  • Flexion brings the forearm closer to the anterior aspect of the arm
  • Extension draws the forearm away from the anterior aspect of the arm
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16
Q

Describe the Proximal and Distal Radioulnar Joints

A
  • Synovial joints (ulna is stable, the radius rotates)
  • Supination directs the palmar surface of the hand anteriorly (palm anterior; anatomical position)
  • Pronation directs the palmar surface of the hand posteriorly (palm posterior)
17
Q

Describe the Wrist (Radiocarpal) Joint

A
  • Synovial joint between the distal radius, articular disc, and 3 out of the 4 proximal carpals (scaphoid, lunate, and triquetrum); the distal ulna does not contribute to this joint; the fibrocartilaginous articular disc lies between the distal ulna and the proximal row of carpals
  • Flexion brings the palm of the hand closer to the anterior aspect of the forearm
  • Extension draws the palm away from the anterior aspect of the forearm
  • Abduction (radial deviation) draws the hand away from the midline of the body
  • Adduction (ulnar deviation) draws the hand towards the midline of the body
18
Q

Describe the Carpometacarpal (CMC) Joints

A
  • Synovial joints between the carpals and the metacarpals
  • Movement of the thumb primarily occurs at this joint
  • Extension of thumb (draws thumb lateral to the palmar surface of the hand)
  • Flexion of thumb (draws thumb medially across the palmar surface of the hand)
  • Abduction of the thumb (draws thumb anterior to the palmar surface of the hand)
  • Adduction of the thumb (draws thumb back from abduction)
  • Opposition of the thumb (draws thumb to bring the tip toward tip of the pinkie)
  • Reposition of the thumb (returns to anatomical position)
19
Q

Describe the Metacarpophalangeal (MCP) Joints

A
  • Synovial joints between the metacarpals and the proximal phalanges
  • Extension of fingers (away from the palmar surface of the hand)
  • Flexion of fingers (towards the palmar surface of the hand)
  • Abduction of the fingers (away from a line passing through the third digit)
  • Adduction of the fingers (towards a line passing through the third digit)
20
Q

Describe the Interphalangeal (IP) Joints

A
  • Hinge synovial joints between the phalanges
  • Proximal interphalangeal joints (PIPs): between proximal & middle phalanges
  • Distal interphalangeal joints (DIPs): between middle & distal phalanges
  • The pollex has a single IP joint between its proximal & distal phalanges
  • Flexion of fingers (towards the palmar surface of the hand)
  • Extension of fingers (away from the palmar surface of the hand)
21
Q

What are the Fascia of the Upper Extremity?

A
  • Superficial fascia: Contains: fat, cutaneous nerves, superficial veins, lymphatic vessels, lymph nodes
  • Deep fascia: Dense connective tissue (very strong)
22
Q

Describe the Deep fascia of the Upper Extremity

A
  • Dense connective tissue (very strong)
  • Includes the following subdivisions: pectoral fascia, deltoid fascia, axillary fascia, brachial fascia, antebrachial fascia, palmar fascia (with central thickening called the palmar aponeurosis)
  • In the arm, the brachial fascia gives rise to two septa that divide the arm into 2 compartments: anterior and posterior
  • In the forearm, the antebrachial fascia gives rise to a septum; this septum and the interosseous membrane divide the forearm into 2 compartments: anterior and posterior
  • Near the wrist joint, the antebrachial fascia forms flexor and extensor retinacula; these bands keep the tendons in place
23
Q

Describe Veins of the Upper Extremity

A
  • There are superficial and deep veins in the upper extremity
  • The deep veins parallel the arteries, and we will study these in subsequent labs
  • There are perforating veins connecting the superficial and deep veins
24
Q

What are the Superficial veins of the Upper Extremity?

A
  • Dorsal venous network (on dorsal aspect of the hand)
  • Cephalic vein
  • Basilic vein
  • Median cubital vein (site of venipuncture)
25
Q

Describe the Cephalic vein

A
  • Arises from the lateral aspect of the dorsal venous network
  • Travels along the lateral aspect of the forearm and arm
  • Enters the deltopectoral triangle (space between deltoid, pectoralis major, and the clavicle) and drains into the axillary vein
26
Q

Describe the Basilic vein

A
  • Arises from medial aspect of the dorsal venous network
  • Courses along the medial aspect of the forearm and arm
  • Joins the brachial veins to form the axillary vein
27
Q

Describe the Median cubital vein (site of venipuncture)

A
  • Arises from the cephalic vein
  • Crosses superficial in the cubital fossa
  • Empties into the basilic vein
  • A common variation: median antebrachial vein, which divides into median cephalic and median basilic veins (important to know about this variation as venipuncture is common in this region)
28
Q

Describe Superficial Lymphatics of the Upper Extremity

A
  • Superficial lymphatic vessels accompanying the cephalic vein first drain into deltopectoral or axillary lymph nodes (note: if drainage is first to the deltopectoral nodes, the lymph then drains to the axillary nodes)
  • Superficial lymphatic vessels accompanying the basilic vein first drain into the cubital lymph nodes, then drain into the axillary lymph nodes
29
Q

Describe Deep Lymphatics of the Upper Extremity

A
  • Deep lymphatic vessels accompany deep veins & drain into the axillary lymph nodes
  • Inflammation of the axillary lymph nodes may indicate infections/pathologies in the upper extremity, but they are also a site for metastasis of breast cancer (recall that superficial tissues superior to the umbilicus drain towards the axillary lymph nodes)
30
Q

Describe the Brachial Plexus

A
  • Network of nerves in the neck and axilla that gives rise to the motor and sensory nerves of the upper extremity (including the pectoral region)
  • Formed by the ventral rami of C5-T1
  • We will study the brachial plexus in more detail during the Axilla/Arm lab
31
Q

Describe Dermatomes of the Upper Extremity

A

Note the distribution of the dermatomes associated with the upper extremity (although there are two dermatome maps in use, note the general trend: superior cervical levels (e.g., C4-C5) near shoulder and inferior cervical levels (e.g., C6-C8) in hand)

Anatomy Exam 3 (6 decks)

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