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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
what percentage of adult fractures are clavicle breaks
2-5%
26
what type of shoulder dissociation is most common
- anterior = due to lack of rotatory cuff muscles present
27
what nerve is at risk of injury in an anterior dislocation of the shoulder
- axillary
28
what does a shoulder dislocation look like
- loss of the round profile | - may end up with sensory loss of the regimental patch due to damage to the axillary nerve
29
describe the prevalence of the anterior dislocation
- 1-7% of the population | - recurrence rate is 50-89%
30
what movement does the deltoid muscle do
abduction
31
what happens if you have deltoid paralysis
- weakness in abduction of the arm - loss of loudness of the shoulder - numbness over regimental badge
32
describe the muscles responsible for abduction in the arm
- Supraspinatus is responsible for the first 10 degrees | - then deltoid is responsible for the 10-180 degrees
33
How do you repair a deltoid muscle injury
- 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
what are the 5 groups of the axillary lymph nodes
- Pectoral - humeral - central - apical - supraclavicualr - sub scapular
35
where does the upper limb have its lymphatic drainage
- upper limb lymph mainly drains into humeral and central nodes
36
describe the lymphatic drainage of the breast
- Lateral breasts drain to the axillary nodes | - medial breast drains to the parasternal nodes
37
Describe what causes the movement of the scapula allowing the shoulder to abduct 180 degrees
- 120 degrees from the glenohumeral joint - 80 degrees from the scapula thoracic joint - trapeziums and serratus anterior cause these muscles to rotate
38
what gives the scapula even more range
Physiological scapulothoracic joint
39
what muscles are important for abduction of the shoulder
- trapezius and serratus anterior cause these muscles to rotate
40
when there is removal of the axillary lymph nodes what can there be damage to
- 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
what moves do lastissimus dorsi and serrates anterior do
- adduction and extension
42
what happens If you remove the lymph nodes
lymphedema as the excess interstitial fluid struggles to be drained
43
when is the long thoracic nerve at risk
- axillary lymph node removal - stab wound - thoracic surgery - chest tube insertion - crushed between clavicle and 1st rib
44
what happens if the spinal accessory nerve is damaged
- 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
what is the biggest bone in the upper limb
Humerus
46
what is damaged by a mid shaft fracture of the humerus
radial nerve
47
what is damaged by an anterior discloation of the elbow
brachial artery
48
what is damaged by a supracondylar fracture of the humerus
- Median nerve
49
in a medial epicondyle break what nerve is damaged
Ulnar nerve as the ulnar never goes under the medial epicondyle
50
what type of joint is the elbow joint
hinge joint - flexion and extension | pivot joint - pronation and supination
51
what is the role fo the elbow
- the elbow positions you hand so you can get the object towards you
52
what is medial the radius or ulna
ulna
53
what are the joints between the radius and ulna
- distal and proximal radioulnar joint
54
what carpals articulates with the radius
scaphoid (larger one) and lunate
55
what is present in the anterior compartment of the forearm
- Flexors - Pronators - Median nerve - Ulnar nerve - Radial artery - Ulnar artery
56
what is in the posterior compartment of the forearm
- Extensors - Supinators - Posterior compartment supplied by radial nerve - Posterior interosseus artery
57
what nerve supplies the posterior compartments of the arm and forearm
radial nerve
58
what artery supplies the posterior compartment of the forearm
- posterior interssoesus which branches of the ulnar artery supplies the posterior compartment
59
which artery is bigger the ulnar or radial artery
ulnar
60
where does the ulnar and radial artery start
- opposite the neck of the radius in the inferior cubital fossa
61
where do the radial and ulnar arteries anatomise
- they anatomise in the hand where they form the deep and superficial palmar arches
62
what are the bones in the hand
carpals metacarpals phalanges
63
what are the joints in the hand
Ditsal radioulnar radiocarpal intercarpals carpometacarpals, metacapalphalangeals interphalangeals (distal and proximal)
64
does the ulnar articulate with carpals
- no instead fibrocartilage disc fills the gap | - allows adduction of the wrist
65
where are the power muscles of the hand located
in the forearm = they have long tendons that pass over the wrist into the hand
66
what are the tendons wrapped in in the hand
- tendon sheath which has synovial fluid in it, allows the tendons to move smoothly and allows them to hold them in place
67
what holds the tendons in place in the hand
- retinaculum - thick fascia that holds the tendons in place
68
what is a collet fracture (dinner fork deformity)
- this is a fracture to the distal radius and ulnar
69
describe a scaphoid fracture
- 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
what nerve is compressed in carpal tunnel syndrome
- the median nerve = can eventually lead to atrophy of the thenar muscles
71
what are bursa
these are synovial fluid bumps where the synovial fluid cannot drain
72
what are the compartments of the hand
Superficial the long flexor tendons and their sheaths Medial and lateral the hypothenar and thenar muscles Deep the intrinsic muscles of the hand
73
describe the blood supply of the hand
- 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
what percentage of movement does the thumb account for
- 50% of movements = does opposition movements
75
what can you use to replace the thumb
the big toe or 2nd toe can be used so you can still to opposition movements

Locomotor 2 (30 decks)

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