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Duke-NUS MS1 > RA6 Upper Limb Anatomy > Flashcards

RA6 Upper Limb Anatomy Flashcards

1
Q

Pectoral girdle:
An (…) ring formed by the (…) and (…), connected to the (…) of the sternum

A

An incomplete ring formed by the scapulae and clavicles, connected to the manubrium of the sternum

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2
Q

Label the 4 segments of the upper limb

A
  1. Shoulder: pectoral girdle (clavicle + scapula)
  2. Arm: humerus
  3. Forearm: radius + ulna
  4. Hand: carpus + metacarpus + phalanges
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3
Q

The (…) end of the clavicle articulates with the (…) of the sternum at the (…) joint

A

The sternal end of the clavicle articulates with the manubrium of the sternum at the sternoclavicular joint

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4
Q

The medial two thirds of the clavicle are (…) anteriorly, while the lateral third is (…) anteriorly

concave/convex

A

The medial two thirds of the clavicle are convex anteriorly, while the lateral third is concave anteriorly

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5
Q

The scapula overlies the (…) through (…) ribs

A

The scapula overlies the 2nd through 7th ribs

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6
Q

Label the bones of the upper limb (anterior view)

A
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7
Q

Label the bones of the upper limb (posterior view)

A
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8
Q

Label the right scapula

A
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9
Q

Label the proximal end of the ulna (lateral view)

A
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10
Q

Label the distal end of the radius (posterior view)

A
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11
Q

Label the bones of the hand

A

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

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12
Q

What are the superficial veins of the upper limb? (5)
Label them

A
  • 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)
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13
Q

What are the deep veins of the upper limb? (7)

Label them

A
  • Subclavian veins
  • Axillary vein
  • Brachial veins
  • Radial veins
  • Ulnar veins
  • Deep venous palmar arch
  • Superficial venous palmar arch
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14
Q

What are the major arteries of the upper limb? (7)

Label them and their sites of palpation

A
  • 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
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15
Q

Which artery provides the main blood supply to the upper limb?

A

Axillary artery

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16
Q

The axio-appendicular muscles are (…) shoulder muscles. They attach the (…) to the (…). They act at the (…) joint.

A

The axio-appendicular muscles are extrinsic shoulder muscles. They attach the superior appendicular skeleton to the axial skeleton. They act at the scapulothoracic joint.

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17
Q

What are the anterior axio-appendicular muscles? (4)
Label them

A
  • Pectoralis major
  • Pectoralis minor
  • Subclavius
  • Serratus anterior
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18
Q

What are the posterior axio-appendicular muscles? Superficial (2) and deep (3)

Label them

A

Superficial:
- Trapezius (descending/superior, middle, ascending/inferior parts)
- Latissimus dorsi

Deep:
- Levator scapulae
- Rhomboid major
- Rhomboid minor

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19
Q

The scapulohumeral muscles are (…) shoulder muscles. They attach the (…) to the (…). They act at the (…) joint.

A

The scapulohumeral muscles are intrinsic shoulder muscles. They attach the scapula to the humerus. They act at the glenohumeral (shoulder) joint.

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20
Q

What are the scapulohumeral muslces? (6)
Label them

A
  • Deltoid: clavicular (anterior), acromial (middle) spinal (posterior) parts
  • Teres major
  • Teres minor
  • Supraspinatus
  • Infraspinatus
  • Subscapularis
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21
Q

What are the rotator cuff muscles and what is their function? (SITS)

A
  • 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

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22
Q

Label the parts of the axilla (6)

A
  • Apex (cervico-axillary canal)
  • Base (forms axillary fossa - armpit)
  • Anterior wall
  • Posterior wall
  • Medial wall
  • Lateral wall
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23
Q

What is the function of the axilla?

A
  • 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.
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24
Q

What are the branches of the 3 parts of the axillary artery?

A

First part:
- Superior thoracic artery

Second part:
- Thoracoacromial artery
- Lateral thoracic artery

Third part:
- Subscapular artery
- Anterior circumflex humeral artery
- Posterior circumflex humeral artery

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25
Q

The axillary artery is a continuation of the (…) artery. It ends at the (…), where it becomes the (…) artery.

A

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.

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26
Q

The axillary vein is a continuation of the (…) vein. It ends at the (…), where it becomes the (…) vein.

A

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.

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27
Q

What are the axillary lymph nodes? (5)

A
  • Pectoral (anterior) nodes
  • Subscapular (posterior) nodes
  • Humeral (lateral) nodes
  • Central nodes
  • Apical nodes
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28
Q

What is the drainage pathway of the axillary lymph nodes?

A
  • 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
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29
Q

What is the brachial plexus?

A

A major network of nerves supplying the upper limb

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30
Q

The brachial plexus is formed by the union of the (…) rami of the (…)-(…) nerves

A

The brachial plexus is formed by the union of the anterior rami of he C5-T1 nerves

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31
Q

Label the structure of the brachial plexus

A

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)

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32
Q

What are the main muscles of the arm? (5)
Label them

A
  • 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
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33
Q

The brachial artery passes through the (…) groove

A

The brachial artery passes through the medial biciptial groove

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34
Q

What are the major nerves of the arm? (4)
Label them

A
  • 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)
35
Q

What is the cubital fossa?
What are its boundaries?

A
  • 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

36
Q

Flexor-pronator muscles of the forearm are located (…) and are innervated by the (…) nerve.

Exception: (…) - flexor located (…) and innervated by the (…) nerve.

A

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.

37
Q

Extensor-supinator muscles of the forearm are located (…) and are innvervated by the (…) nerve.

A

Extensor-supinator muscles of the forearm are located posteriorly and are innvervated by the radial nerve.

38
Q

What are the flexor-pronator muscles of the forearm? (3 layers)

Label them

A

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

39
Q

What are the extensor muscles of the forearm? (10)

Label them

A

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)

40
Q

The common extensor tendon attaches which muscles (4) to the lateral epicondyle?

A
  • Extensor carpi radialis brevis (ECRB)
  • Extensor carpi ulnarus (ECU)
  • Extensor digitorum
  • Extensor digiti minimi
41
Q

What does the intertendinous connection do?

A

It links adjacent tendons of the extensor digitorum, restricting independent extension of fingers

42
Q

What are the major nerves of the forearm? (3)

A
  • Median nerve
  • Ulnar nerve
  • Radial nerve
43
Q

What are the two eminences of the palmar aspect of the hand?

A
  • Thenar eminence (base of thumb)
  • Hypothenar eminence (base of 5th finger)
44
Q

What are the 5 components of the hand and what muscles do they contian?

A
  • Thenar compartment: thenar muscles
  • Hypothenar compartment: hypothenar muscles
  • Adductor compartment: adductor pollicis
  • Central compartment: lumbircals, flexor tendons
  • Interosseous compartment: interossei
45
Q

What are the thenar muscles grouped according to their functions?

(abduction, adduction, extension, flexion, opposition)

A
  • 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
46
Q

What are the hypothenar muscles of the hand?

A
  • Abductor digiti minimi
  • Flexor digiti minimi brevis
  • Opponens digiti minimi
47
Q

What is the plamaris brevis?

A
  • Located in the hypothenar eminence
  • Wrinkles the skin of the hypothenar eminence, deepening the hollow of the palm, aiding palmar grip
48
Q

What are the short hand muscles?

A
  • Lumbricals (4)
  • Interossei (4 dorsal, 3 palmar)
49
Q

The dorsal interossei (…) the fingers while the palmar interossei (…) the fingers

A

DAB/PAD:
The dorsal interossei abduct the fingers while the palmar interossei adduct the fingers

50
Q

What does the fibrous digital sheath contain?

A

The fibrous digital sheath contains the flexor tendons and their synovial sheaths

51
Q

The (…) nerve supplies no hand muscles

A

The radial nerve supplies no hand muscles

52
Q

The (…) nerve innervates muscles that are concerned with intricate hand movements

A

The ulnar nerve innervates muscles that are concerned with intricate hand movements

53
Q

The (…) (SC) joint lies between the (…) end of the (…), the (…) of the sternum, and the (…)

A

The sternoclavicular (SC) joint lies between the sternal end of the clavicle, the manubrium of the sternum, and the first costal cartilage

54
Q

Label the parts of the sternoclavicular joint

A
  • Articular disc
  • Joint capsule
  • Anterior and posterior SC ligaments
  • Interclavicular ligament
  • Costoclavicular ligament
55
Q

The (…) (AC) joint is located where the (…) end of the (…) articulates with the (…)

A

The acromioclavicular (AC) joint is located where the acromial end of the clavicle articulates with the acromion

56
Q

Label the parts of the acromioclavicular joint

A
  • Superior AC ligament
  • Coracoclavicular ligament (conoid ligament + trapezoid ligament)
57
Q

The (…) (GH) joint is located where the (…) articulates with the (…) of the scapula

A

The glenohumeral joint is located where the humeral head articulates with the glenoid cavity of the scapula

58
Q

The humeral head is held in the glenoid cavity by which muscles?

A

Rotator cuff muscles (SITS):
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis

59
Q

Which part of the glenohumeral joint is the weakest?

A

The inferior part of the joint capsule - it is the only part not reinforced by the rotator cuff muscles

60
Q

What are the ligaments of the glenohumeral joint?
Label them

A
  • Coracohumeral ligament
  • Transverse humeral ligament
  • Coraco-acromial ligament
61
Q

What makes up the coraco-acromial arch? What is its function?

A

Coracoid process + coraco-acromial ligament + acromion = coraco-acromial arch

Function: overlies the head of the humerus, preventing its superior displcement from the glenoid cavity

62
Q

Which joint in the body has the most freedom of movement?

A

Glenohumeral joint

63
Q

The (…) muscles act indirectly on the glenohumeral joint while the (…) muscles act directly on it

A

The axio-appendicular muscles act indirectly on the glenohumeral joint while the scapulohumeral muscles act directly on it

64
Q

What are the burase aroud the glenohumeral joint? (2)
Label them

A
  • Subacromial bursa
  • Subscapular bursa
65
Q

The elbow joint is located where the (…) articulates with the (…) (humero-ulnar) and the (…) articulates with the (…) (humero-radial)

A

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)

66
Q

What are the ligaments of the elbow joint? (2)
Label them

A
  • Radial collateral ligament
  • Ulnar collateral ligament - 3 bands: anterior (cord-like; strongest), posterior (fan-like; weakest), (oblique; deepens socket for trochlea of humerus)
67
Q

What is the carrying angle of the elbow joint?

A

170 degrees

68
Q

What are the bursae around the elbow joint? (3)
Label them

A
  • Intratendinous olecranon bursa
  • Subtendinous olecranon bursa
  • Subcutaneous olecranon bursa
69
Q

Articulation of the proximal radio-ulnar joint

A

Head of radius articulates with radial notch of ulnar

70
Q

What is the ligament of the proximal radio-ulnar joint?

A

Anular ligament of radius - completely encircles head of raidus, holding it in the radial notch of the ulnar

71
Q

Articulation of distal radio-ulnar joint

A

Head of ulna articulates with ulnar notch of radius

72
Q

What does the articular disc of the distal radioulnar joint do?

A
  • 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
73
Q

During prontion and supination of the arm, it is the (…) that rotates

A

During prontion and supination of the arm, it is the radius that rotates

74
Q

Which muscles produce supination of the forearm?

A
  • Supinator (resistance absent)
  • Biceps brachii (resistance present)
75
Q

Which muscles produce pronation of the forearm?

A
  • Pronator quadratus (primarily)
  • Pronator teres (secondarily)
76
Q

Which nerve is responsible for pronation of the forearm?

A

Median nerve

77
Q

Which nerves are responsible for supination of the forearm?

A

Musculocutaneous and radial nerves

78
Q

What are the joints of the hand?
Label them

A
  • 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)
79
Q

The (…) lies deep to the palmaris longus tendon

A

The median nerve lies deep to the palmaris longus tendon

80
Q

The median nerve lies deep to the (…)

A

The median nerve lies deep to the palmaris longus tendon

81
Q

What does the carpal tunnel contain?

A

Flexor tendons and the median nerve

82
Q

Which nerves innervate extensor and flexor muscles?

A
  • Extensor muscles: radial nerve
  • Flexor muscles: ulnar and median nerves
83
Q
A

Duke-NUS MS1 (12 decks)

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