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Locomotor 2 > Review of the Upper Limb > Flashcards

Review of the Upper Limb Flashcards

1
Q

What elements is the shoulder between

A

Between the thorax and the arm includes the pectoral girdle

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2
Q

what bones make up the shoulder

A
  • clavicle
  • scapula
  • humerus
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3
Q

What are the three joints in the shoulder

A
  • sternoclavicular
  • acromoclavicular
  • glenohumeral
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4
Q

what is the shoulder designed for

A

mobility and to have the greatest range of movement possible

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5
Q

What type of joint is the glenohumeral joint

A
  • ball and socket synovial joint
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6
Q

What type of joint is the sternoclavicular joint

A

saddle synovial joint

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7
Q

What type of joint is the acromoclavicular joint

A

plane synovial joint

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8
Q

what joint is the only joint that attaches the arm to the axial skeleton

A
  • sternoclavicular
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9
Q

describe the arterial blood supply to the arm

A

subclavian artery supplies the arm

  • this turns into the axillary artery when it passes via the lateral border of the 1st rib to the inferior border of trees major
  • the axially artery gives of the medial and lateral circumflex artery which supply the shoulder
  • it turns into the brachial artery once it passes the inferior border of trees
  • the brachial artery then splits into the radial and ulnar artery
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10
Q

describe the superifical venous supply to the arm

A

Superficial veins

- cephalic (more medial) and basilic (more lateral)

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11
Q

what is the nerve roots of the brachial plexus

A

C5-T1

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12
Q

name the branches of brachial plexus

A
  • Musculotaneous
  • median
  • ulnar
  • axially
  • radial
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13
Q

describe the different cords of the brachial plexus

A

Anterior cord (lateral to medial)

  • Musculocutaneous
  • Median
  • Ulnar

Posterior cord

  • Axillary
  • Radial
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14
Q

what does the musculotaneous nerve supply and the nerve roots

A

C5-C7

- brachialis, biceps brachii and coracobrachialis muscles.

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15
Q

What does the median nerve supply and the nerve roots

A

C5-T1

  • most of the flexor in the forearm
  • thenar muscles

sensory
- Gives off the palmar cutaneous branch, which innervates the lateral part of the palm, and the digital cutaneous branch, which innervates the lateral three and a half fingers on the anterior (palmar) surface of the hand.

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16
Q

What does the ulnar nerve supply and the nerve roots

A

C8 and T1

  • flexor carpi ulnaris and medial half of flexor digitorum profundus.
  • intrinsic muscles of the hand

sensory
- Innervates the anterior and posterior surfaces of the medial one and half fingers, and associated palm area.

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17
Q

What does the radial nerve supply and the nerve roots

A

C5 – T1

- the extensors of the forearm

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18
Q

What does the radial nerve supply and the nerve roots

A

C5 – T1
- the extensors of the forearm

sensory
- the posterior aspect of the arm and forearm, and the posterolateral aspect of the hand.

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19
Q

what two types of forces that can cause a clavicle break

A
  • direct or indirect force
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20
Q

when is a clavicle break a medical emergency

A
  • tingling or reduced peripheral pulses - medical emergency
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21
Q

What does a clavicle break look like and why

A
  • looks like tenting
    SCM - this causes the clavicle to move upwards

gravity causes the clavicles to move down

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22
Q

what causes a direct clavicle break

A
  • something lands on the shoulder
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23
Q

What causes an indirect clavicle break

A
  • this is when you land with your hands stretched out and the end point of the upper limb is the clavicle and this is where the force is applied
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24
Q

where about is the fracture usually in the clavicle

A

2/3 of the way in the clavicle

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25
Q

what percentage of adult fractures are clavicle breaks

A

2-5%

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26
Q

what type of shoulder dissociation is most common

A
  • anterior = due to lack of rotatory cuff muscles present
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27
Q

what nerve is at risk of injury in an anterior dislocation of the shoulder

A
  • axillary
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28
Q

what does a shoulder dislocation look like

A
  • loss of the round profile

- may end up with sensory loss of the regimental patch due to damage to the axillary nerve

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29
Q

describe the prevalence of the anterior dislocation

A
  • 1-7% of the population

- recurrence rate is 50-89%

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30
Q

what movement does the deltoid muscle do

A

abduction

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31
Q

what happens if you have deltoid paralysis

A
  • weakness in abduction of the arm
  • loss of loudness of the shoulder
  • numbness over regimental badge
32
Q

describe the muscles responsible for abduction in the arm

A
  • Supraspinatus is responsible for the first 10 degrees

- then deltoid is responsible for the 10-180 degrees

33
Q

How do you repair a deltoid muscle injury

A
  • use muscle transfer
  • therefore you get pec major and flip it over to replace deltoid and then you use the medial and lateral pectoral nerves to replace the axillary nerve
  • use pec major as you can liver without it as there are other muscles that already do the same job
34
Q

what are the 5 groups of the axillary lymph nodes

A
  • Pectoral
  • humeral
  • central
  • apical
  • supraclavicualr
  • sub scapular
35
Q

where does the upper limb have its lymphatic drainage

A
  • upper limb lymph mainly drains into humeral and central nodes
36
Q

describe the lymphatic drainage of the breast

A
  • Lateral breasts drain to the axillary nodes

- medial breast drains to the parasternal nodes

37
Q

Describe what causes the movement of the scapula allowing the shoulder to abduct 180 degrees

A
  • 120 degrees from the glenohumeral joint
  • 80 degrees from the scapula thoracic joint
  • trapeziums and serratus anterior cause these muscles to rotate
38
Q

what gives the scapula even more range

A

Physiological scapulothoracic joint

39
Q

what muscles are important for abduction of the shoulder

A
  • trapezius and serratus anterior cause these muscles to rotate
40
Q

when there is removal of the axillary lymph nodes what can there be damage to

A
  • injury to the throacodorsal nerve and thus the latissmus doors
  • injury to the long thoracic nerve which innervates serrates anterior and thus can cause winging of the scapula
41
Q

what moves do lastissimus dorsi and serrates anterior do

A
  • adduction and extension
42
Q

what happens If you remove the lymph nodes

A

lymphedema as the excess interstitial fluid struggles to be drained

43
Q

when is the long thoracic nerve at risk

A
  • axillary lymph node removal
  • stab wound
  • thoracic surgery
  • chest tube insertion
  • crushed between clavicle and 1st rib
44
Q

what happens if the spinal accessory nerve is damaged

A
  • weak shoulder abduction and not as prominent winging of scapula
  • atrophy of trapezius
  • shoulder falls
  • cannot abduct beyond 70-90 degrees as you cannot rotate the scapula
45
Q

what is the biggest bone in the upper limb

A

Humerus

46
Q

what is damaged by a mid shaft fracture of the humerus

A

radial nerve

47
Q

what is damaged by an anterior discloation of the elbow

A

brachial artery

48
Q

what is damaged by a supracondylar fracture of the humerus

A
  • Median nerve
49
Q

in a medial epicondyle break what nerve is damaged

A

Ulnar nerve as the ulnar never goes under the medial epicondyle

50
Q

what type of joint is the elbow joint

A

hinge joint - flexion and extension

pivot joint - pronation and supination

51
Q

what is the role fo the elbow

A
  • the elbow positions you hand so you can get the object towards you
52
Q

what is medial the radius or ulna

A

ulna

53
Q

what are the joints between the radius and ulna

A
  • distal and proximal radioulnar joint
54
Q

what carpals articulates with the radius

A

scaphoid (larger one) and lunate

55
Q

what is present in the anterior compartment of the forearm

A
  • Flexors
  • Pronators
  • Median nerve
  • Ulnar nerve
  • Radial artery
  • Ulnar artery
56
Q

what is in the posterior compartment of the forearm

A
  • Extensors
  • Supinators
  • Posterior compartment supplied by radial nerve
  • Posterior interosseus artery
57
Q

what nerve supplies the posterior compartments of the arm and forearm

A

radial nerve

58
Q

what artery supplies the posterior compartment of the forearm

A
  • posterior interssoesus which branches of the ulnar artery supplies the posterior compartment
59
Q

which artery is bigger the ulnar or radial artery

A

ulnar

60
Q

where does the ulnar and radial artery start

A
  • opposite the neck of the radius in the inferior cubital fossa
61
Q

where do the radial and ulnar arteries anatomise

A
  • they anatomise in the hand where they form the deep and superficial palmar arches
62
Q

what are the bones in the hand

A

carpals
metacarpals
phalanges

63
Q

what are the joints in the hand

A

Ditsal radioulnar

radiocarpal

intercarpals

carpometacarpals,

metacapalphalangeals

interphalangeals (distal and proximal)

64
Q

does the ulnar articulate with carpals

A
  • no instead fibrocartilage disc fills the gap

- allows adduction of the wrist

65
Q

where are the power muscles of the hand located

A

in the forearm = they have long tendons that pass over the wrist into the hand

66
Q

what are the tendons wrapped in in the hand

A
  • tendon sheath which has synovial fluid in it, allows the tendons to move smoothly and allows them to hold them in place
67
Q

what holds the tendons in place in the hand

A
  • retinaculum - thick fascia that holds the tendons in place
68
Q

what is a collet fracture (dinner fork deformity)

A
  • this is a fracture to the distal radius and ulnar
69
Q

describe a scaphoid fracture

A
  • problem with the scaphoid is the blood supply becoming affected
  • snuffbox - if you feel in this you might be able to feel the breakage
70
Q

what nerve is compressed in carpal tunnel syndrome

A
  • the median nerve = can eventually lead to atrophy of the thenar muscles
71
Q

what are bursa

A

these are synovial fluid bumps where the synovial fluid cannot drain

72
Q

what are the compartments of the hand

A

Superficial the long flexor tendons and their sheaths

Medial and lateral the hypothenar and thenar muscles

Deep the intrinsic muscles of the hand

73
Q

describe the blood supply of the hand

A
  • superficial and deep palmer arches which are supplied from the radius and ulnar and is where the radius and ulnar anatomise so there is collateral circulation
  • Digital arteriais that are going into the fingers
74
Q

what percentage of movement does the thumb account for

A
  • 50% of movements = does opposition movements
75
Q

what can you use to replace the thumb

A

the big toe or 2nd toe can be used so you can still to opposition movements

Locomotor 2 (30 decks)

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