RA6 Upper Limb Anatomy Flashcards
Pectoral girdle:
An (…) ring formed by the (…) and (…), connected to the (…) of the sternum
An incomplete ring formed by the scapulae and clavicles, connected to the manubrium of the sternum
Label the 4 segments of the upper limb
- Shoulder: pectoral girdle (clavicle + scapula)
- Arm: humerus
- Forearm: radius + ulna
- Hand: carpus + metacarpus + phalanges
The (…) end of the clavicle articulates with the (…) of the sternum at the (…) joint
The sternal end of the clavicle articulates with the manubrium of the sternum at the sternoclavicular joint
The medial two thirds of the clavicle are (…) anteriorly, while the lateral third is (…) anteriorly
concave/convex
The medial two thirds of the clavicle are convex anteriorly, while the lateral third is concave anteriorly
The scapula overlies the (…) through (…) ribs
The scapula overlies the 2nd through 7th ribs
Label the bones of the upper limb (anterior view)
Label the bones of the upper limb (posterior view)
Label the right scapula
Label the proximal end of the ulna (lateral view)
Label the distal end of the radius (posterior view)
Label the bones of the hand
Carpals (8, lateral to medial):
- Proximal row: scaphoid (+ tubercle), lunate, triquetrum, pisiform
- Distal row: trapezium (+ tubercle), trapzoid, capitate, hamate (+ hook)
Metacarpals (5):
- Base, shaft, head
Phalanges (3 for each finger):
- Proximal, middle, distal
- Each has a base, shaft, and head
What are the superficial veins of the upper limb? (5)
Label them
- Cephalic vein (lateral)
- Basilic vein (medial)
- Median cubital vein (joins cephalic and basilic veins)
- Median antebrachial cutaneous vein
- Perforating veins (form communications between superficial and deep veins)
What are the deep veins of the upper limb? (7)
Label them
- Subclavian veins
- Axillary vein
- Brachial veins
- Radial veins
- Ulnar veins
- Deep venous palmar arch
- Superficial venous palmar arch
What are the major arteries of the upper limb? (7)
Label them and their sites of palpation
- Subclavian artery
- Axillary artery (axilla)
- Brachial artery (cubital fossa)
- Radial artery (lateral wrist, anatomical snuff box)
- Ulnar artery (medial wrist)
- Deep palmar arch
- Superficial palmar arch
Which artery provides the main blood supply to the upper limb?
Axillary artery
The axio-appendicular muscles are (…) shoulder muscles. They attach the (…) to the (…). They act at the (…) joint.
The axio-appendicular muscles are extrinsic shoulder muscles. They attach the superior appendicular skeleton to the axial skeleton. They act at the scapulothoracic joint.
What are the anterior axio-appendicular muscles? (4)
Label them
- Pectoralis major
- Pectoralis minor
- Subclavius
- Serratus anterior
What are the posterior axio-appendicular muscles? Superficial (2) and deep (3)
Label them
Superficial:
- Trapezius (descending/superior, middle, ascending/inferior parts)
- Latissimus dorsi
Deep:
- Levator scapulae
- Rhomboid major
- Rhomboid minor
The scapulohumeral muscles are (…) shoulder muscles. They attach the (…) to the (…). They act at the (…) joint.
The scapulohumeral muscles are intrinsic shoulder muscles. They attach the scapula to the humerus. They act at the glenohumeral (shoulder) joint.
What are the scapulohumeral muslces? (6)
Label them
- Deltoid: clavicular (anterior), acromial (middle) spinal (posterior) parts
- Teres major
- Teres minor
- Supraspinatus
- Infraspinatus
- Subscapularis
What are the rotator cuff muscles and what is their function? (SITS)
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
(these are scapulohumeral muscles)
Function: hold the humeral head in the glenoid cavity of the scapula during movement of the glenohumeral (shoulder) joint
Label the parts of the axilla (6)
- Apex (cervico-axillary canal)
- Base (forms axillary fossa - armpit)
- Anterior wall
- Posterior wall
- Medial wall
- Lateral wall
What is the function of the axilla?
- It provides a passageway for vessels and nerves going to and from the upper limb.
- It contains the axillary artery/vein, branchial plexus, lympathic vessles, and lymph nodes, all embedded in axillary fat.
What are the branches of the 3 parts of the axillary artery?
First part:
- Superior thoracic artery
Second part:
- Thoracoacromial artery
- Lateral thoracic artery
Third part:
- Subscapular artery
- Anterior circumflex humeral artery
- Posterior circumflex humeral artery
The axillary artery is a continuation of the (…) artery. It ends at the (…), where it becomes the (…) artery.
The axillary artery is a continuation of the subclavian artery. It ends at the inferior border of the teres major, where it becomes the brachial artery.
The axillary vein is a continuation of the (…) vein. It ends at the (…), where it becomes the (…) vein.
The axillary vein is a continuation of the brachial vein. It ends at the lateral border of the first rib, where it becomes the subclavian vein.
What are the axillary lymph nodes? (5)
- Pectoral (anterior) nodes
- Subscapular (posterior) nodes
- Humeral (lateral) nodes
- Central nodes
- Apical nodes
What is the drainage pathway of the axillary lymph nodes?
- Upper limb -> humeral (lateral) nodes
- Posterior thoracic wall + scapular -> subscapular (posterior) nodes
- Anterior thoracic wall + breast -> pectoral (anterior) nodes
- Humeral + subscapular + pectoral nodes -> central nodes -> apical nodes -> supraclavicular nodes -> subclavian lympathic trunk -> right/left venous angle
What is the brachial plexus?
A major network of nerves supplying the upper limb
The brachial plexus is formed by the union of the (…) rami of the (…)-(…) nerves
The brachial plexus is formed by the union of the anterior rami of he C5-T1 nerves
Label the structure of the brachial plexus
Roots -> trunks -> divisions -> cords
5 roots:
- C5, C6, C7, C8, T1
3 trunks:
- Superior (C5 + C6)
- Middle (C7)
- Inferior (C8 + T1)
6 divisions (one pair for each trunk):
- 3 anterior
- 3 posterior
3 cords:
- Lateral (anterior div of superior and middle trunks)
- Medial (anterior div of inferior trunk)
- Posterior (posterior div of all 3 trunks)
What are the main muscles of the arm? (5)
Label them
- Biceps brachii (2 heads: long and short)
- Brachialis (the only pure elbow flexor, produces greatest amount of flexion force)
- Coracobrachialis
- Tricpes brachii (primary elbow extensor; 3 heads: long, lateral, medial)
- Anconeus
The brachial artery passes through the (…) groove
The brachial artery passes through the medial biciptial groove
What are the major nerves of the arm? (4)
Label them
- Median nerve (medial + lateral cords, C5-C8, T1)
- Radial nerve (posterior cord, C5-C8, T1)
- Ulnar nerve (medial cord, C7-C8, T1)
- Musculocutaneous nerve (lateral cord, C5-C7)
What is the cubital fossa?
What are its boundaries?
- The cubital fossa is the shallow triangular depression on the anterior surface of the elbow.
Boundaries:
- Superiorly: imaginary line onnecting medial and lateral epicondyles of humerus
- Medially: pronator teres
- Laterally: brachioradialis
Flexor-pronator muscles of the forearm are located (…) and are innervated by the (…) nerve.
Exception: (…) - flexor located (…) and innervated by the (…) nerve.
Flexor-pronator muscles of the forearm are located anteriorly and are innervated by the median nerve.
Exception: brachioradialis - flexor located posteriorly and innervated by the radial nerve.
Extensor-supinator muscles of the forearm are located (…) and are innvervated by the (…) nerve.
Extensor-supinator muscles of the forearm are located posteriorly and are innvervated by the radial nerve.
What are the flexor-pronator muscles of the forearm? (3 layers)
Label them
Superficial layer (4):
- Pronator teres
- Flexor carpi radialis (FCR)
- Flexor carpi ulnaris (FCU)
- Palmaris
Intermediate layer (1):
- Flexor digitorum superficialis (FDC)
Deep layer (3):
- Flexor digitorum profundus (FDP)
- Flexor pollicis longus (FPL)
- Pronator quadratus
What are the extensor muscles of the forearm? (10)
Label them
Extend hand at wrist joint:
- Extensor carpi radialis longus (ECRL)
- Extensor carpi radialis brevis (ECRB)
- Extensor carpi ulnaris (ECR)
Extend medial four digits:
- Extensor digitorum
- Extensor indicis
- Extensor digiti minimi (EDM)
Extend thumb:
- Abductor pollicis longus (APL)
- Extensor pollicis brevis (EPB)
- Extensory pollicis longus (EPL)
The common extensor tendon attaches which muscles (4) to the lateral epicondyle?
- Extensor carpi radialis brevis (ECRB)
- Extensor carpi ulnarus (ECU)
- Extensor digitorum
- Extensor digiti minimi
What does the intertendinous connection do?
It links adjacent tendons of the extensor digitorum, restricting independent extension of fingers
What are the major nerves of the forearm? (3)
- Median nerve
- Ulnar nerve
- Radial nerve
What are the two eminences of the palmar aspect of the hand?
- Thenar eminence (base of thumb)
- Hypothenar eminence (base of 5th finger)
What are the 5 components of the hand and what muscles do they contian?
- Thenar compartment: thenar muscles
- Hypothenar compartment: hypothenar muscles
- Adductor compartment: adductor pollicis
- Central compartment: lumbircals, flexor tendons
- Interosseous compartment: interossei
What are the thenar muscles grouped according to their functions?
(abduction, adduction, extension, flexion, opposition)
- Abduction: abductor pollicis longus and brevis
- Adduction: adductor pollicis, 1st dorsal interosseous
- Extension: extensor pollicis and brevis, abductor pollicis longus
- Flexion: flexor pollicis longus and brevis
- Opposition: opponens pollicis
What are the hypothenar muscles of the hand?
- Abductor digiti minimi
- Flexor digiti minimi brevis
- Opponens digiti minimi
What is the plamaris brevis?
- Located in the hypothenar eminence
- Wrinkles the skin of the hypothenar eminence, deepening the hollow of the palm, aiding palmar grip
What are the short hand muscles?
- Lumbricals (4)
- Interossei (4 dorsal, 3 palmar)
The dorsal interossei (…) the fingers while the palmar interossei (…) the fingers
DAB/PAD:
The dorsal interossei abduct the fingers while the palmar interossei adduct the fingers
What does the fibrous digital sheath contain?
The fibrous digital sheath contains the flexor tendons and their synovial sheaths
The (…) nerve supplies no hand muscles
The radial nerve supplies no hand muscles
The (…) nerve innervates muscles that are concerned with intricate hand movements
The ulnar nerve innervates muscles that are concerned with intricate hand movements
The (…) (SC) joint lies between the (…) end of the (…), the (…) of the sternum, and the (…)
The sternoclavicular (SC) joint lies between the sternal end of the clavicle, the manubrium of the sternum, and the first costal cartilage
Label the parts of the sternoclavicular joint
- Articular disc
- Joint capsule
- Anterior and posterior SC ligaments
- Interclavicular ligament
- Costoclavicular ligament
The (…) (AC) joint is located where the (…) end of the (…) articulates with the (…)
The acromioclavicular (AC) joint is located where the acromial end of the clavicle articulates with the acromion
Label the parts of the acromioclavicular joint
- Superior AC ligament
- Coracoclavicular ligament (conoid ligament + trapezoid ligament)
The (…) (GH) joint is located where the (…) articulates with the (…) of the scapula
The glenohumeral joint is located where the humeral head articulates with the glenoid cavity of the scapula
The humeral head is held in the glenoid cavity by which muscles?
Rotator cuff muscles (SITS):
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
Which part of the glenohumeral joint is the weakest?
The inferior part of the joint capsule - it is the only part not reinforced by the rotator cuff muscles
What are the ligaments of the glenohumeral joint?
Label them
- Coracohumeral ligament
- Transverse humeral ligament
- Coraco-acromial ligament
What makes up the coraco-acromial arch? What is its function?
Coracoid process + coraco-acromial ligament + acromion = coraco-acromial arch
Function: overlies the head of the humerus, preventing its superior displcement from the glenoid cavity
Which joint in the body has the most freedom of movement?
Glenohumeral joint
The (…) muscles act indirectly on the glenohumeral joint while the (…) muscles act directly on it
The axio-appendicular muscles act indirectly on the glenohumeral joint while the scapulohumeral muscles act directly on it
What are the burase aroud the glenohumeral joint? (2)
Label them
- Subacromial bursa
- Subscapular bursa
The elbow joint is located where the (…) articulates with the (…) (humero-ulnar) and the (…) articulates with the (…) (humero-radial)
The elbow joint is located where the trochlea articulates with the trochlea notch (humero-ulnar) and the capitulum articulates with the head of radius (humero-radial)
What are the ligaments of the elbow joint? (2)
Label them
- Radial collateral ligament
- Ulnar collateral ligament - 3 bands: anterior (cord-like; strongest), posterior (fan-like; weakest), (oblique; deepens socket for trochlea of humerus)
What is the carrying angle of the elbow joint?
170 degrees
What are the bursae around the elbow joint? (3)
Label them
- Intratendinous olecranon bursa
- Subtendinous olecranon bursa
- Subcutaneous olecranon bursa
Articulation of the proximal radio-ulnar joint
Head of radius articulates with radial notch of ulnar
What is the ligament of the proximal radio-ulnar joint?
Anular ligament of radius - completely encircles head of raidus, holding it in the radial notch of the ulnar
Articulation of distal radio-ulnar joint
Head of ulna articulates with ulnar notch of radius
What does the articular disc of the distal radioulnar joint do?
- It binds the ends of the ulna and radius together
- It separates the cavity of the distal radio-ulnar joint from the cavity of the wrist joint
During prontion and supination of the arm, it is the (…) that rotates
During prontion and supination of the arm, it is the radius that rotates
Which muscles produce supination of the forearm?
- Supinator (resistance absent)
- Biceps brachii (resistance present)
Which muscles produce pronation of the forearm?
- Pronator quadratus (primarily)
- Pronator teres (secondarily)
Which nerve is responsible for pronation of the forearm?
Median nerve
Which nerves are responsible for supination of the forearm?
Musculocutaneous and radial nerves
What are the joints of the hand?
Label them
- Wrist joint (radiocarpal joint)
- Intercarpal joints (btwn carpals of same row)
- Midcarpal joints (btwn carpals of diff rows)
- Carpometacarpal joints (btwn carpals and metacarpals)
- Intermetacarpal joints (btwn metacarpals)
- Metacarpophalangeal joints (btwn metacarpals and phalanges)
- Proximal interphalangeal joints (btwn proximal and middle phalanx)
- Distal interphalangeal joints (btwn middle and distal phalanx)
The (…) lies deep to the palmaris longus tendon
The median nerve lies deep to the palmaris longus tendon
The median nerve lies deep to the (…)
The median nerve lies deep to the palmaris longus tendon
What does the carpal tunnel contain?
Flexor tendons and the median nerve
Which nerves innervate extensor and flexor muscles?
- Extensor muscles: radial nerve
- Flexor muscles: ulnar and median nerves
