Savarese Ch 7: Upper Extremities Flashcards by Daniel Long

Name to muscles of the rotator cuff:

A trigger point

S: supraspinatus
I: Infraspinatus
T: Teres minor
S: Subscapularis

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What is the action of supraspinatus

ABduction of the arm

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What is the action of infraspinatus

External rotation of arm

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What is the action of the Teres minor

External rotation of the arm

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What is the action of the subscapularis

Internal rotation of the arm

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What is the primary flexor of the shoulder?

Deltoid (anterior portion)

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What is the primary ABductor of the shoulder?

Deltoid (middle portion)

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What are the primary extensors of the shoulder?

Latissimus dorsi
Teres Major
Deltoid (Posterior portion)

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What are the primary ADductors of the shoulder

Pectoralis Major

Latissimus dorsi

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What are the primary external rotators of the shoulder

Infraspinatus

Teres Minor

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What is the primary internal rotator of the shoulder

Subscapularis

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Explain why the path of the subclavian artery is clinically significant

It passes between the anterior and middle scalenes.
Contracture of these may compromise arterial supply to the arm. (venous drainage not affected b/c the subclavian vein passes anterior to the anterior scalene)

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Subclavian artery –> _____ at the _______

Subclavian artery –> Axiallary artery at the lateral border of the first rib

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Axillary artery –> _____ at the _______

Axillary artery –> Brachial artery at the inferior border of the teres minor

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What is the first major branch of the brachial artery? Where does it course?

Profunda brachial artery

Accompanies the radial nerve in its posterior course of the radial groove.

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Brachial artery –> ____________ at _____

Brachial artery –> ulnar & radial arteries under the bicipital aponeurosis

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Radial artery: supplies ____; Forms ____

Supplies: elbow, wrist, dorsal aspect of the hand
Forms: most of the DEEP palmar arterial arch

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Ulnar artery: Supplies ____; Forms ____

Supplies: elbow, wrist, dorsal aspect of the hand
Forms: Most of the SUPERFICIAL palmar arterial arch

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What supplyes the nerves to the Upper extremity (UE)?

The brachial plexus

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What composes the brachial plexus (general)? (5)

C5-T1
ROOTS exit the spinal cord and form -->
TRUNKS -->
DIVISIONS -->
CORDS -->
BRANCHES

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Can you (still) draw the brachial plexus?

Picture on pg 60

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Which 2 tests/techniques are good screening examinations for gross range of motion of the shoulder?

Apley’s Scratch test

2. Spencer Technique: for more accurately testing individual motions of the shoulder

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What is the most common somatic dysfunction of the shoulder?

Restriction in internal and external rotation

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What is the 2nd most common somatic dysfunction of the shoulder?

Restriction in ABduction

What is the least common somatic dysfunction of the shoulder?

Restriction in Extension

What is the most common somatic dysfunction of the sternoclavicular joint?

Clavicle, anterior and superior on the sternum

What 3 ligaments stabilize the acromioclavicular joint?

1. Acromioclavicular ligament 2. Coracoacromial 3. Coracoclavicular

What is the most common somatic dysfunction of the acromioclavicular joint?

Clavicle, superior and lateral on the acromion

What is Bicipital tenosynovitis?

Inflammation of the TENDON and ITS SHEATH of the LONG HEAD OF THE BICEPS

What causes winging of the scapula?

Usually a weakness of the anterior serratus muscle due to a long thoracic nerve injury

What is Erb-Duchenne's palsy?

The most common form of brachial plexus injury. | An upper arm paralysis caused by injury to C5 and C6 nerve roots usually during childbirth

What is Klympke's palsy?

Due to injury to C8 and T1 - paralysis usually occurs in the intrinsic muscles of the hand.

What do you know about radial nerve injury

the most common nerve injured in the UE due to direct trauma. Injured in the spiral groove in humeral fractures.

What is Saturday night palsy?

Compression of the radial nerve against the humerus

Primary flexors of the hand and wrist: Origin: innervation:

O: medial epicondyle of the humers IN: most = median nerve

Primary extensors of the hand and wrist: Origin: Innervation

O: lateral epicondyle of the humerus IN: All = radial nerve

Primary supinators of the forarm: | Name and innervation

Biceps - musculocutaneous nerve | Supinator: radial nerve

Primary pronators of the forearm: | Name and innervation

Pronator teres AND | Pronator quadratus --> BOTH = median nerve

Muscles in the thenar eminence are innervated by the _____

Median nerve | EXCEPT ADductor pollicis BREVIS --> Ulnar n

Muscles in the hypothenar eminence and interossi are innervated by the ____

ulnar nerve

What is the innervation of the lumbricals?

1st and 2nd = median nerve | 3rd and 4th = ulnar nerve

What are the normal carrying angles?

Men: 5 degrees Women: 10-12 degrees

What is cubitus valgus or abduction of the ulna

carrying angle > 15 degrees

What is cubitus varus or ADduction of the ulna?

Carrying angle < 3 degrres

An increase in the carrying angle (ABduction of the ulna) will cause an ______ of the wrist

ADduction of the wrist

When the forearm is pronated, the radial head will glide ____

Posteriorly

When the forearm is supinated, the radial head will glide ____

Anteriorly

Etiology of a posterior radial head:

Falling forward on a pronated forearm

Etiology of an anterior radial head:

Falling backward on a supinated forearm

Describe lateral epicondylitis (and its other name)

Tennis elbow --> over use of the extensors, which originate from the lateral epicondyle

Describe medial epicondylitis (and its other name)

Golfer's elbow --> over use of the flexors, which originate from the medial epicondyle

Describe a Swan-neck deformity

Flexion contracture of the MCP and DIP Extension contractor of the PIP Results from a contracture of the intrinsic muscles of the hand

Describe a Boutonniere deformity

Extension contractor of the MCP and DIP Flexion contraction of the PIP Results from a rupture of the hood of the extensor tendon at the PIP

Describe a Claw Hand

Extension of MCP Flexion of PIP and DIP Results from median and ulnar nerve injury

Describe Ape hand

Claw hand + wasting of thenar eminence and ADduction of the thumb. Results from median nerve damage

Describe Bishops deformity

Contraction of the last 2 digits with atrophy of the hypothenayr eminence Due to ulnar nerve damage

Describe Dupuytren's contracture

Flexion contraction of the MCP and PIP usually seen with contracture of the last 2 digits. Due to contracture of the palmar fascia

Describe Drop-wrist deformity

Due to radial nerve damage resulting in paralysis of the extensor muscles