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Upper Limb Anatomy > The Arm > Flashcards

The Arm Flashcards

1
Q

What are the upper limb reflexes and how can you test for them?

A

Biceps reflex (C5/C6) - inthe antecubital fossa, tap overlying the biceps tendon

Triceps reflex (C7) - place forearm rested at 90 degress flexion

Supinator reflex (C6) - located 4 inches proximal to the base of the thumb

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2
Q

What are the myotomes of the arm?

A

Elbow flexors/Biceps - C5
Wrist extensors - C6
Elbow extensors Triceps - C7
Long finger flexors - C8
Small finger abductors - T1

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3
Q

What would be the clinical findings in the C4 nerve root compression?

A

Sensory deficit
- lateral neck and shoulder

Muscle weakness
- scapula

Reflex changes
- none

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4
Q

What would be the clinical findings in a C5 nerve root compression>

A

Sensory deficit
- upper lateral arm and elbow

Muscle weakness
- Deltoid and biceps

Reflex changes
- bicepsWha

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5
Q

What would be the clinical findings in a C6 nerve root compression?>

A

Sensory deficit
- lateral forearm and thumb and index finger

Muscle weakness
- biceps and wrist extensors

Reflex changes
- brachioradialis

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6
Q

What would be the clinical features of a C7 nerve root compression>

A

Sensory deficit
- middle finger

muscle weakness
- triceps
- wrist flexors
- long finger extension

reflex changes
- triceps

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7
Q

What would be the clinical findings in a C8 nerve root compression?

A

Sensory deficit
- little and ring finger
- ulnar border of the palm
- medial forearm

Muscle weakness
- finger flexors

Reflex changes
- none

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8
Q

What would be the clinical features of T1 nerve root compression?

A

Sensory deficit
- medial arm

muscle weakness
- dorsal interossei
- abductor digiti minimi

Reflex changes
- none

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9
Q

Where is the intertubercular groove on the humerus and what runs in it?

A

The anterior aspect of the proximal end of the humerus
Long head of biceps tendon runs through it

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10
Q

Where do the humerus, radius and ulna articulate with each other?

A
  • Capitulum of the humerus and radial head
  • Trochlea of the humerus and the trochlear notch of the ulna
  • Olecranon of the ulna and the olecranon fossa of the humerus
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11
Q

Which muscle flex the elbow joint?

A

Biceps
Brachialis
Brachioradialis
Pronator teres
Flexor carpi radialis

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12
Q

Which structure pass through the spiral groove?

A

Radial nerve
Profunda brachii vessels

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13
Q

What clinical picture would be the result of a radial nerve injury at the spiral groove?

A

Paralysis of the wrist extensors - wrist drop
Paralysis of finger extensors - finger drop
- Loss of sensation of the 1st web space

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14
Q

What injuries are associated with a supracondylar fracture of the humerus?

A
  • Brachial artery injury
  • Anterior interosseous nerve injury (unable to flex the interphalangeal joint of the thumb and DIP of index finger)
  • Ulnar nerve injury (claw hand)
  • Radial nerve injury (wrist drop and finger drop)
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15
Q

What is the origin of the coracobrachialis muscle?

A

Coracoid

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16
Q

Where is the insertion of the coracobrachialis muscle?

A

Mid-humerus (medial)WH

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17
Q

What is the action of the coracobrachialis muscle?

A

Flexion and adduction of the arm

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18
Q

What is the innervation of the coracobrachialis muscle?

A

Musculocutaneous

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19
Q

What is the origin of the biceps brachii?

A

Coracoid (short head)
Supraglenoid (long head)

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20
Q

Where does the biceps brachii insert?

A

Radial tuberosity

Relations of the bicipital tendon
- medial, the median nerve and brachial artery
- lateral, the radial nerve

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21
Q

What is the action of the biceps brachii?

A

Supination and flexion

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22
Q

What is the innervation of the biceps brachii?

A

Musculocutaneous

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23
Q

Where is the origin of the brachialis muscle?

A

Anterior humerus

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24
Q

Where does the brachialis muscle insert?

A

Ulnar tuberosity (anterior)Wh

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25
What is the action of the brachialis muscle?
Flexing the forearm
26
What is the innervation of the brachialis muscle?
Musculocutaneous Radial
27
What is the origin of the triceps brachii?
Infraglenoid (long head) Posterior humerus (lateral head) Posterior humerus (medial nerve) Radial nerve and profunda brachii vessels lie between the medial and lateral heads
28
Where does the triceps brachii insert?
The olecranon
29
What is the action of the triceps brachii?
Extending the forearm (elbow extension) The long head can adduct the humerus and extend it from a flexed position
30
What is the innervation of the triceps brachii?
Radial nerve
31
What is the blood supply of the triceps brachii?
Profunda brachii artery
32
What muscles make up the superficial flexors of the forearm?
Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris Flexor digitorum superficialis
33
What is the origin, insertion, action and innervation of pronator teres?
Origin - medial epicondyle and coronoid Insertion - mid-lateral radius Action - pronating, flexing the forearm Innervation - median nerve
34
What is the origin, insertion, action and innervation of flexor carpi radialis?
Origin - medial epicondyle insertion - 2nd and 3rd MC bases Action - flexing the wrist Innervation - median nerve
35
What are the origin, insertion, action and innervation of palmaris longus|?
Origin - medial epicondyle Insertion - palmar aponeurosis Action - flexing the wrist Innervation - median nerve
36
What are the origins, insertion, actions and innervation of flexor carpi ulnaris?
Origin - medial epicondyle and posterior ulna Insertion - pisiform Action 0 flexing wrist Innervation - ulnar nerve
37
What are the origins, insertions, actions and innervation of flexor digitorum superficialis?
Origin - medial epicondyle, proximal anterior ulna and anterior radius insertion - base of middle phalanges Action - flexing PIP joints Innervation - median nerve
38
What muscles make up the deep flexors of the forearm?
Flexor digitorum profundus Flexor pollicis longus Pronator quadratus
39
What are the origins, insertion, action and innervation of flexor digitorum profundus?
Origin - anterior and medial ulna Insertion - base of the distal phalanges Actions - flexing of the DIP joints Innervation - median -anterior interosseous/ulnar nerves
40
What are the origins, insertions, actions and innervation of flexor pollicis longus?
Origin - anterior and lateral radius Insertion - base of distal phalanges action - flexing IP joint of the thumb Innervation - median- anterior interosseous nerve
41
What are the origins, insertion action and innervations of pronator quadratus?
Origin - distal ulna Insertion - volar radius Action - pronating hand Innervation - median-anterior interosseous nerve
42
What muscles make up the superficial extensors of the forearm?
Brachioradialis Extensor carpi radialis longus Extensor carpi radialis brevis Anconeus Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris
43
What are the origins, insertion, actions and innervation of brachioradialis
Origin - lateral supracondylar humerus Insertion - lateral distal radius Action - flexing forearm Innervation- radial nerve
44
What are the origins, insertion, actions and innervation of Extensor carpi radialis longus?
Origin - lateral supracondylar humerus Insertion- second metacarpal base Action- extending wrist Innervation - Radial nerve
45
What are the origins, insertion, actions and innervation of extensor carpi radialis brevis?
Origin - lateral epicondyle of humerus Insertion - third base of metacarpal Action- extending wrist Innervation - Radial nerve
46
What are the origins, insertion, actions and innervation of anconeus?
Origin - lateral epicondyle of humerus Insertion - Proximal dorsal ulna Action - extending forearm Innervation - Radial nerve
47
What are the origins, insertion, actions and innervation of extensor digitorum?
Origin - Lateral epicondyle of the humerus Insertion - Extensor aponeurosis Action - extending the digits Innervation - Radial-posterior interosseous nerve
48
What are the origins, insertion, actions and innervation of extensor digiti minimi
Origin - common extensor tendon Insertion - Small finger extension expansion over P1 Action - Extending small finger Innervation - Radial-posterior interosseous nerve
49
What are the origins, insertion, actions and innervation of extensor carpi ulnaris
Origin - lateral epicondyle of humerus Insertion - Fifth metacarpal base Action - extending/adducting hand Innervation - Radial posterior interosseous nerve
50
What muscles make up the deep extensors of the forearm
Supinator Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor indicis proprius
51
What are the origins, insertion, actions and innervation of supinator
Origin - lateral epicondyle of humerus Insertion - dorsolateral radius Action - Supinating forearm Innervation - Radial-posterior interosseous nerve
52
What are the origins, insertion, actions and innervation of Abductor pollicis longus
Origin - Dorsal ulna/radius Insertion - First metacarpal base Action - Aducting/extending the thumb Innervation - Radial-posterior interosseous nerve
53
What are the origins, insertion, actions and innervation of extensor pollicis brevis
Origin - Dorsal radius Insertion - Thumb proximal phalanx base Action - Extending thumb MCP joint Innervation - Radial-posterior interosseous nerve
54
What are the origins, insertion, actions and innervation of extensor pollicis longus
Origin - Dorsolateral ulna Insertion - Thumb dorsal phalanx base Action - extending thumb at IP joint Innervation - Radial posterior interosseous nerve
55
What are the origins, insertion, actions and innervation of extensor indicis proprius
Origin - Dorsolateral ulna Insertion - Index finger extensor apparatus (ulnarly) Action - extending the index finger Innervation - Radial posterior interosseous nerve
56
What are the boundaries of the cubital fossa?
Superolateral - brachioradialis muscle Medially - pronator teres Floor - brachialis
57
What are the contents of the cubital fossa?
Medial to lateral - Median nerve - Brachial artery - Biceps tendon
58
What sensory distribution of the median nerve?
Lateral 2/3 of the palm of the head Lateral 3 1/2 digits on the palmar side Dorsum of the tips of the index, middle and thumb
59
What is the median nerve motor distribution in the hand?
LOAF Lateral 2 lumbricals Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis
60
What is the clinical picture of a medial nerve injury at the elbow?
Ape like hand - hyperextended thumb (paralysis of FPB) - Adducted thumb (paralysis of abductor pollicis brevis) - Flat thenar eminence - Loss of sensation from - lateral 2/3 of palm of hand lateral 3 1/2 digits (palmar and distal dorsal aspect)
61
What is the clinical picture of an ulnar nerve injury at the wrist
Complete claw hand - Clawing of the 4th and 5th digits (paralysis of the medial lumbricals and interossei) - loss of sensation of the medial 1/3 of palmar and dorsal aspects of hand and fingers
62
What is the cause of the ulnar paradox?
In proximal ulnar nerve injuries, there will be paralysis of the medial 1/2 of the FDP which will decrease flexion of the IP joints
63
How is the superficial palmar arch formed?
Formed mainly by the arch of the superficial division of the ulnar artery and is completed by the superficial palmar branch of the radial artery
64
Name the carpal bones
Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate Scared Lovers Try Positions That They Cant Handle
65
What is the blood supply of the scaphoid bone?
Receives its blood supply primarily from lateral and distal branches of the radial artery, via palmar and dorsal branches. These provide an abundant supply to the middle and distal bone, but neglects the proximal portion, which relies on retrograde flow
66
How do you test the ulnar artery supply
Allen's test
67
What is the clinical application of Lister's tubercle
Tubercle on the dorsal radius Lighthouse of the wrist - EPL tendon runs around it. It serves as a pulley for the tendon of the EPL which wraps around the medial side and take a 45 degree turn
68
What are the attachments for the flexor retinaculum
Proximal - pisiform - tubercle of scaphoid Distal - hook of hamate - trapezium
69
What structures pass through the carpal tunnel?
4 tendons of flexor digitorum superficialis 4 tendons of flexor digitorum profundus 1 tendon of flexor pollicis longus 1 tendon of flexor carpi radialis median nerve
70
How do you test Flexor digitorum superficialis?
Hold adjacent digits in extension, in order to eliminate FDP motion in adjacent fingers, which otherwise might give the impression of FDS motion in the examined finger
71
Where do they FDS and FDP tendons insert?
FDS - split tendon on both sides of the middle phalanx FDP: Passes through the split tendon of FDS to be inserted into the terminal phalanx
72
Which tendon attaches to the pisiform?
Flexor carpi ulnaris
73
What attaches the extensor tendons to the phalanges?
Extensor expansion
74
What is the function of the intertendinous connections?
Create space between extensor tendons Redistributes force between tendons Coordinates extension of fingers Stabilise MCP joints
75
What are the origins, insertion, actions and innervation of first interosseous
Origin - from the first metacarpal Insertion - into the lateral side of extensor expansion of the index finger Actin - abduction of index finger Innervation - deep branch of ulnar nerve
76
What are the boundaries of the anatomical snuff box?
Posterior border - extensor pollicis longus tendon Anterir border - Extensor pollicis brevis tendon Abductor pollicis longus tendn Proximal border - styloid process of the radius Distal border - Apex of the snuffbox triangle Floor - Trapezium and scaphoid Content - radial artery
77

Upper Limb Anatomy (3 decks)

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