SM 222: Organization of the Upper Limb Flashcards
1
Q
What are the components of a single joint system?
A
Bone(s) Joint(s) Ligaments Muscle(s) Nerves (Motor and Sensory)
2
Q
What connects a bone to a bone?
A
A ligament
3
Q
What is a tendon?
A
Connective tissue that links a bone to a muscle Tendon’s involve muscle to bone because muscle is tender
4
Q
What is a ligament?
A
Connective tissue that links a bone to a bone
5
Q
What connects a bone to a mucle?
A
A tendon Tendon’s involve muscle to bone because muscle is tender
6
Q
What is the function of Deep Fascia in a limb?
A
Deep Fascia separates the limb into compartments in both the upper and lower limbs
7
Q
How are muscles in the same compartment related?
A
Muscles in the same compartment share:
Embryological origin
Nerve and blood supply
Attachment points
Function
8
Q
How do limbs relate to the body wall?
A
Limbs are outgrowths of the body wall and therefore are innervated by spinal nerves
9
Q
Which limb is innervated by the Brachial Plexus?
A
Brachial = Arm
Brachial Plexus innervates the arm
10
Q
What levels and which type of rami feed into the Brachial plexus?
A
Because the Brachial Plexus supplies the arm, and the arm is a limb, it is made of Ventral Rami
Specifically, it is supplied by the C5 - T1 Ventral Rami
11
Q
What are the outputs of the Brachial Plexus and what do they supply?
A
The Brachial Plexus and it’s outputs supply the arm
It’s outputs include MRMU:
Musculocutaneous Nerve
Radial Nerve
Median Nerve
Ulnar Nerve
12
Q
What determines the type and range of motion at a joint?
A
The shape of the articulation determines the type and range of motion at a joint
13
Q
What are ball and socket joints?
A
Joints that permit movement on several axes
Ex = Shoulder and Hip
14
Q
What are condylar joints?
A
Joints with 2 different radii of curvature that allow for motion in one major and one minor direction
Ex = Knee
15
Q
What are hinge joints?
A
Joints that permit motion in only one direction
Ex = Elbow
16
Q
How does joint mobility relate to stability?
A
More mobile joints are inherently less stable and more prone to injury
17
Q
What type of joint is most mobile?
A
Ball and socket joints
18
Q
What is the most mobile joint in the body?
A
The shoulder, a ball and socket joint
19
Q
What tpe of joint permits motion in one major and one minor axis?
A
A condylar joint such as the knee
20
Q
What type of joint permits motion in only one direction?
A
A hinge joint permits motion in only one direction, such as the elbow
21
Q
What type of joint permits motion in many axes?
A
Ball and socket, because it’s the most mobile, such as the shoulder
22
Q
What type of joint is most stable?
A
A hinge joint is most stable, such as the elbow
23
Q
What are ligaments made of and how do they protect joints?
A
Ligaments = connective tissue
Limit range of motion + prevent movement in unwanted direction
24
Q
What is a “sprain”?
A
Damage to a ligament
25
What are the general roles of muscles?
Generate forces to move the body and stabilize the body against other forces
26
What should you think about when framing a muscle?
It's name, attachment, action, and innervation
Probably set by it's compartment
27
How can you tell if a muscle acts on a joint?
Muscles only act on joints they cross
28
What are muscle protagonists and antagonists and why are they relevant?
Protagonist muscles perform an action
Antagonist muscles perform the opposite action
The muscles work together to protect joints and ensure smooth movement
29
What are the protagonists and antagonists in extension of the elbow?
Extension = moving elbow to straigthen arm
```
Protagonist = triceps
Antagonist = biceps
```
30
What are the protagonists and antagonists in flexion of the elbow?
Flexion = curling the elbow
```
Protagonist = biceps
Antagonist = triceps
```
31
What region does the "arm" refer to?
Arm = shoulder to elbow
32
What region does the "forearm" refer to?
Forearm = elbow to wrist
33
What are the 5 joints of the shoulder region?
Glenohumeral = Humerus + Scapula + Clavicle
Acromioclavicular
Coracoclavicular
Sternoclavicular = Clavicle + Sternum
Scapulothoracic (fake)
34
Why is the Sternoclavicular joint important?
The Clavicle meets the Sternum at the Sternoclavicular joint
This is the only way to connect the Scapula to the Axial skeleton, since Glenohumeral is ball and socket and Acromio/Coracoclavicular hold shoulder together but don't connect to the Axial skeleton
35
What joint connects the Scapula to the Axial body wall?
It technically isn't directly connected and is free to move against the dorsal body wall
However, the Sternoclavicular joint connects the Clavicle to the Sternum, and the Scapula is connected to the Sternum
36
Which shoulder joint is a Synnovial joint?
Acromioclavicular Joint
37
Which shoulder joint is purely ligaments?
Coracoclavicular
38
Which shoulder joint is the largest?
Glenohumeral, connecting the Glenoid surface of the Scapula to the head of the Humerus
39
What bones and what parts of those bones does the Glenohumeral joint connect?
Glenohumeral = Scapula + Humerus
Glenoid Surface of Scapula
Head of Humerus
40
What type of motion is the Glenohumeral joint capable of and why?
The Glenohumeral joint can move in all 3 planes:
Abduction/Adduction
Flexion/Extension
Internal and External Rotation
Circumduction = Ab/Ad + Flex/Ext
41
Compare Abduction and Adduction?
Abduction is moving away from the midline
Adduction is moving toward the midline
42
Compare Flexion and Extension?
Flexion is increasing the angle between two things
Extension is decreasing the angle between two things
At the shoulder, flexion is moving arm forward and extensino is moving arm backward
43
Compare Medial and Lateral Rotation?
Medial rotation involves a joint rotating towards the midline
Lateral rotation involves a joing rotating away from the midline
At the shoulder, with the arm at a right angle, Medial is rotating inward while lateral is outward
44
What type of motion does the Acromioclavicular joint facilitate?
The AC joint is a synnovial joint and only allows vor very small sliding motion
Anchors the scapula to the clavicle
45
What type of motion does the Coracoclavicular joint allow?
A fibrous joint that links the coracoid process of the scapula to the clavicle, it allows very little motion
46
Explain the basis of separated shoulder?
Separated shoulder occurs if the Acromiclavicular joint or the Coracoclavicular joint were to be severed
The Scapula is no longer anchored to the Clavicle, and as a result, the shoulder sags
47
What is the importance of the Sternoclavicular joint?
It allows for the arm to move relative to a fixed Axial body
48
Why is the Scapolothoracic "joint" not real?
It isn't an actual joint, the Scapula is just embedded in muscle which can freely move around the posterior thoracic body wall
49
What is the Scapulothoraic Rhythm?
Because the Scapula is not physically held to the body wall, the Scapula itself can rotate in addition to the movement caused by the joints it's linked to
The Scapulothoracic Rhythm refers to 2 degrees of movement in the Glenohumeral joint to 1 degree of rotation of the Scapula itself
50
Are the ligaments of the Glenohumeral joint strong, and why or why not?
Most are weak to allow for range of motion at the cost of stability
Exception is the very strong Coracromial Ligament, which prevents dislocation of the Humerus
51
What is the role of the Coracromial Ligament and where does it act?
The Coracromial Ligament is found in the shoulder at the Glenhumeral joing prevens upward dislocation of the Humerus
It's strong
52
What are the major sources of stability in the Glenhumeral joint?
The major sources of stability are the tendons of rotator cuff muscles and the Coracoaromial Ligament
53
What defines a rotator cuff muscle?
The tendons of a rotator cuff muscle fuse with the capsulse of the Glenhumeral joint
54
What are the shoulder Extensors?
DLT
Deltoid
Latissimus Dorsi
Triceps Brachii
55
What are the shoulder Flexors?
Flexors = DPB
Deltoid
Pectoralis Major
Biceps Brachii
56
Which muscles are shoulder Abductors?
Abductors = DS
Deltoid
Supraspinatus
57
What are the shoulder Adductors?
Adductors = LT
Latissimus Dorsi
Teres Major
58
What are the shoulder internal rotators?
Internal = TS
Teres Major
Subscapularis
59
What are the shoulder external rotators?
External = IT
Infraspinatus
Teres minor
60
What is the major mediator of shoulder flexion and what nerve supplies it?
Bicepsi Brachii and Musculocutaneous mediate shoulder flexion
61
What is the major mediator of shoulder extension and what nerve supplies it?
The Triceps brachii is the major mediator of shoulder extension, and it is supplied by the Radial nerve
62
What are the major mediators of shoulder abduction and what nerves supply them?
Deltoid and Supraspinatus
Axillary and Suprascapular
63
What are the major mediators of shoulder adduction and what nerves supply them?
Latissimus Dorsi and Teres major by Subscapular Nerve
Pectoralis major by Lateral Pectoral Nerve
64
What are the major mediators of shoulder internal rotation and what nerves supply them?
Teres and major and Subscapularis
Subscapular nerve
65
What are the major mediators of shoulder external rotation and what nerves supply them?
Infraspinatus and Teres minor
Suprascapular and Axillary nerves
66
What are the 4 rotator cuff muscles?
SSIT
Supraspinatus
Subscapularis
Infraspinatus
Teres minor
67
What quandrant of the rotator cuff is mostly likely to dislocate and why?
The anterior-inferior quadrant is mostly likely to dislocate because it is not reinforced by a rotator cuff muscle
68
Which compartment of the arm is a flexor and which is extensor?
```
Anterior = flexor
Posterior = extensor
```
69
What muscles are found in the flexor compartment of the arm and what action do they mediate?
Biceps Brachii (superficial)
Brachialis
Coracobrachialis (deep)
All mediate flexion of shoulder and elbow
70
What nerve supplies the anterior compartment of the arm and what mucles are found there?
The Musculocutaneous Nerve supplies:
Biceps Brachii
Coracobrachialis
Brachialis
All in the anterior compartment of the arm
71
What skeletal landmarks are found in the anterior compartment of the arm and which muscles are they associated with?
Coracoid Process + Radial Tuberosity
Coracoid Process = Biceps brachii and Coracobrachialis
Radial Tuberosity = Biceps brachii and Brachialis
72
What muscle in the anterior compartment is associated with two skeletal landmarks, and which ones?
Biceps brachii is associated with 2 landmarks:
Coracoid Process + Radial Tuberosity
73
What is the major muscle of the posterior component of the arm, what action does it perform, and what nerve supplies it?
Muscle = Triceps brachii
Extends shoulder and elbow
Supplied by Radial nerve
74
What is the skeletal landmark of the posterior arm?
The olecranon process of the ulna
75
What is the wrist flexor of the anterior forearm?
Wrist flexor = flexor carpi radialis
76
What are the wrist and digital flexors of the anterior forearm?
Flexor digitorum sperfucialis
Flexor digitorum profundus
Flexor pollicis longus
77
What are the forearm pronators?
Pronator teres
Pronator quandruatus
78
What actions are performed by muscles in the anterior compartment of the forearm?
Anterior = flexion
Flexing the wrist and/or digits
Pronating the forearm
79
What nerves supply the anterior forearm?
Ulnar nerve to flexor digitorum profundus
Median nerve to everything else
80
What is the skeletal landmark of the forearm?
The Medial epicondyle of the humerus
81
What are the general types of muscles in the anterior forearm?
Pure wrist flexors
Wrist and Digital flexors
Forearm Pronators
82
What is the wrist extensor of the posterior forearm?
Extensor capri radialis
83
What are the wrist and digit extensors of the posterior forearm?
Extensor digitorum
Extensor pollicis
84
What is the thumb abductor for the posterior forearm?
Abductor pollicis longus
85
What is the forearm supinator of the posterior forearm?
Supinator
86
What actiosn are performed by the posterior forearm?
Extending the wrist and/or digits
Abduct the thumb
Supinate the forearm
87
What nerve supplies the posterior forearm?
Radial nerve for everything
88
What is the skeletal landmark of the posterior forearm?
The lateral epicondyle of the humerus
Unlike the anterior forearm, which has the medial epicondly of the humerus as a landmark
89
What nerve exiting the Brachial plexus supplies the Deltoid?
Axillary Nerve (Ventral Rami)
90
What are the 3 anterior compartment nerves of the arm and forearm?
```
Arm = musculocutaneous nerve for Flexion
Forearm = median + ulnar nerves for Flexion + Pronation
```
91
What actions are controlled by the Axillary nerve?
Shoulder abduction and lateral rotation
92
What actions are controlled by the Radial nerve?
Extension of shoulder, elbow, wrist, digits
Supination via Supinator
93
Whatactions are controlled by Musculocutaneous nerve?
Flexion of shoulder and elbow
Supination via Biceps brachii
94
What actions are controlled by the Median nerve?
Flexion of Wrist, Digits, Thumb
Pronation
Thumb opposition, abduction
95
What actions are controlled by the Ulnar nerve?
Flexion of the Wrist, DIP of digits 4 and 5, MCP
Digit abduction, adduction
Extension of IP
96
What is the Labrum?
The Labrum is a fibrocartilagenous attachment that enlarge the Glenoid of the Scapula
The Labrum may tear off and cause a SLAP lesion
97
Which muscle(s) Flex the shoulder and what nerve(s) innervate them?
Biceps Brachii - Musculocutaenous
98
Which muscle(s) Extend the shoulder and what nerve(s) innervate them?
Triceps Brachii - Radial
99
Which muscle(s) Abduct the shoulder and what nerve(s) innervate them?
DS
Deltoid - Axillary
Supraspinatus - Suprascapular
100
Which muscle(s) Adduct the shoulder and what nerve(s) innervate them?
LTP
Latissimus Dorsi - Subscapular
Teres Major - Subscapular
Pectoralis Major - Lateral Pectoral
101
Which muscle(s) Medially Rotate the shoulder and what nerve(s) innervate them?
TS
Teres Major = Subscapular
Subscapularis = Subscapular
102
Which muscle(s) Laterally Rotate the shoulder and what nerve(s) innervate them?
IT (like outsourced = external)
Infraspinatus = Suprascapular
Teres Minor = Axillary
103
What nerve innervates the Subscapularis muscle, and what action does it meditate?
Subscapular nerve innervates Subscapularis
Medial rotation of shoulder
104
What nerve innervates the Supraspinatus and what action does it mediate?
The Suprasapular nerve innervates the Supraspinatus
Abduction of the shoulder
105
What nerve innervates the Infraspinatus, and what action does it mediate?
The Suprascapular nerve innervates the Infraspinatus
Lateral rotation of the shoulder
106
What nerve innervates Teres minor and what action does it mediate?
The Axillary nerve innervates Teres minor and the Deltoid
Teres minor is a lateral rotator of the shoulder
107
What does the Long Thoracid Nerve innervates?
Serratus Anterior
108
What are the branches of the Posterior Cord of the Brachial Plexus?
SAR
Subscapular - Lat Dorsi, Teres Major
Axillary - Delts, Teres Minor
Radial - Posterior Arm and Forearm
109
What do the Subscapular nerves innervate, and which cord of the Brachial Plexus do they derive from?
Latissimus Dorsi and Teres Major
Posterior Cord
110
What do the Axillary nerves innervate, and which cord of the Brachial Plexus do they derive from?
Deltoid and Teres Minor
Posterior Cord
111
What do the Radial nerves innervate, and which cord of the Brachial Plexus do they derive from?
Posterior Arm and Posterior Forearm
Posterior Cord
112
What are the branches of the Medial and Lateral Cords of the Brachial Plexus and what do they innervate?
UMM
Ulnar - ulnar forearm and instrinsic hand
Median - radial forearm, thenar compartment
Musculocutaneous - anterior arm
113
What do the Ulnar nerves innervate, and which cord of the Brachial Plexus do they derive from?
Ulnar forearm, intrinsic hand
Medial/Lateral Cords
114
What do the Median nerves innervate, and which cord of the Brachial Plexus do they derive from?
Radial Forearm, Thenar Compartment
Medial/Lateral Cords
115
What do the Musculocutaneous nerves innervate, and which cord of the Brachial Plexus do they derive from?
Anterior Arm
Medial/Lateral Cords
