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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
Q

What is the action of the brachialis muscle?

A

Flexing the forearm

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26
Q

What is the innervation of the brachialis muscle?

A

Musculocutaneous
Radial

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27
Q

What is the origin of the triceps brachii?

A

Infraglenoid (long head)
Posterior humerus (lateral head)
Posterior humerus (medial nerve)

Radial nerve and profunda brachii vessels lie between the medial and lateral heads

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28
Q

Where does the triceps brachii insert?

A

The olecranon

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29
Q

What is the action of the triceps brachii?

A

Extending the forearm (elbow extension)
The long head can adduct the humerus and extend it from a flexed position

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30
Q

What is the innervation of the triceps brachii?

A

Radial nerve

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31
Q

What is the blood supply of the triceps brachii?

A

Profunda brachii artery

32
Q

What muscles make up the superficial flexors of the forearm?

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Flexor digitorum superficialis

33
Q

What is the origin, insertion, action and innervation of pronator teres?

A

Origin - medial epicondyle and coronoid

Insertion - mid-lateral radius

Action - pronating, flexing the forearm

Innervation - median nerve

34
Q

What is the origin, insertion, action and innervation of flexor carpi radialis?

A

Origin - medial epicondyle

insertion - 2nd and 3rd MC bases

Action - flexing the wrist

Innervation - median nerve

35
Q

What are the origin, insertion, action and innervation of palmaris longus|?

A

Origin - medial epicondyle

Insertion - palmar aponeurosis

Action - flexing the wrist

Innervation - median nerve

36
Q

What are the origins, insertion, actions and innervation of flexor carpi ulnaris?

A

Origin - medial epicondyle and posterior ulna

Insertion - pisiform

Action 0 flexing wrist

Innervation - ulnar nerve

37
Q

What are the origins, insertions, actions and innervation of flexor digitorum superficialis?

A

Origin - medial epicondyle, proximal anterior ulna and anterior radius

insertion - base of middle phalanges

Action - flexing PIP joints

Innervation - median nerve

38
Q

What muscles make up the deep flexors of the forearm?

A

Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

39
Q

What are the origins, insertion, action and innervation of flexor digitorum profundus?

A

Origin - anterior and medial ulna

Insertion - base of the distal phalanges

Actions - flexing of the DIP joints

Innervation - median -anterior interosseous/ulnar nerves

40
Q

What are the origins, insertions, actions and innervation of flexor pollicis longus?

A

Origin - anterior and lateral radius

Insertion - base of distal phalanges

action - flexing IP joint of the thumb

Innervation - median- anterior interosseous nerve

41
Q

What are the origins, insertion action and innervations of pronator quadratus?

A

Origin - distal ulna

Insertion - volar radius

Action - pronating hand

Innervation - median-anterior interosseous nerve

42
Q

What muscles make up the superficial extensors of the forearm?

A

Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Anconeus
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris

43
Q

What are the origins, insertion, actions and innervation of brachioradialis

A

Origin - lateral supracondylar humerus

Insertion - lateral distal radius

Action - flexing forearm

Innervation- radial nerve

44
Q

What are the origins, insertion, actions and innervation of Extensor carpi radialis longus?

A

Origin - lateral supracondylar humerus

Insertion- second metacarpal base

Action- extending wrist

Innervation - Radial nerve

45
Q

What are the origins, insertion, actions and innervation of extensor carpi radialis brevis?

A

Origin - lateral epicondyle of humerus

Insertion - third base of metacarpal

Action- extending wrist

Innervation - Radial nerve

46
Q

What are the origins, insertion, actions and innervation of anconeus?

A

Origin - lateral epicondyle of humerus

Insertion - Proximal dorsal ulna

Action - extending forearm

Innervation - Radial nerve

47
Q

What are the origins, insertion, actions and innervation of extensor digitorum?

A

Origin - Lateral epicondyle of the humerus
Insertion - Extensor aponeurosis

Action - extending the digits

Innervation - Radial-posterior interosseous nerve

48
Q

What are the origins, insertion, actions and innervation of extensor digiti minimi

A

Origin - common extensor tendon

Insertion - Small finger extension expansion over P1

Action - Extending small finger

Innervation - Radial-posterior interosseous nerve

49
Q

What are the origins, insertion, actions and innervation of extensor carpi ulnaris

A

Origin - lateral epicondyle of humerus

Insertion - Fifth metacarpal base

Action - extending/adducting hand

Innervation - Radial posterior interosseous nerve

50
Q

What muscles make up the deep extensors of the forearm

A

Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis proprius

51
Q

What are the origins, insertion, actions and innervation of supinator

A

Origin - lateral epicondyle of humerus

Insertion - dorsolateral radius

Action - Supinating forearm

Innervation - Radial-posterior interosseous nerve

52
Q

What are the origins, insertion, actions and innervation of Abductor pollicis longus

A

Origin - Dorsal ulna/radius

Insertion - First metacarpal base

Action - Aducting/extending the thumb

Innervation - Radial-posterior interosseous nerve

53
Q

What are the origins, insertion, actions and innervation of extensor pollicis brevis

A

Origin - Dorsal radius

Insertion - Thumb proximal phalanx base

Action - Extending thumb MCP joint

Innervation - Radial-posterior interosseous nerve

54
Q

What are the origins, insertion, actions and innervation of extensor pollicis longus

A

Origin - Dorsolateral ulna

Insertion - Thumb dorsal phalanx base

Action - extending thumb at IP joint

Innervation - Radial posterior interosseous nerve

55
Q

What are the origins, insertion, actions and innervation of extensor indicis proprius

A

Origin - Dorsolateral ulna

Insertion - Index finger extensor apparatus (ulnarly)

Action - extending the index finger

Innervation - Radial posterior interosseous nerve

56
Q

What are the boundaries of the cubital fossa?

A

Superolateral - brachioradialis muscle

Medially - pronator teres

Floor - brachialis

57
Q

What are the contents of the cubital fossa?

A

Medial to lateral
- Median nerve
- Brachial artery
- Biceps tendon

58
Q

What sensory distribution of the median nerve?

A

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
Q

What is the median nerve motor distribution in the hand?

A

LOAF

Lateral 2 lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

60
Q

What is the clinical picture of a medial nerve injury at the elbow?

A

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
Q

What is the clinical picture of an ulnar nerve injury at the wrist

A

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
Q

What is the cause of the ulnar paradox?

A

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
Q

How is the superficial palmar arch formed?

A

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
Q

Name the carpal bones

A

Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate

Scared Lovers Try Positions That They Cant Handle

65
Q

What is the blood supply of the scaphoid bone?

A

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
Q

How do you test the ulnar artery supply

A

Allen’s test

67
Q

What is the clinical application of Lister’s tubercle

A

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
Q

What are the attachments for the flexor retinaculum

A

Proximal
- pisiform
- tubercle of scaphoid

Distal
- hook of hamate
- trapezium

69
Q

What structures pass through the carpal tunnel?

A

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
Q

How do you test Flexor digitorum superficialis?

A

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
Q

Where do they FDS and FDP tendons insert?

A

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
Q

Which tendon attaches to the pisiform?

A

Flexor carpi ulnaris

73
Q

What attaches the extensor tendons to the phalanges?

A

Extensor expansion

74
Q

What is the function of the intertendinous connections?

A

Create space between extensor tendons
Redistributes force between tendons
Coordinates extension of fingers
Stabilise MCP joints

75
Q

What are the origins, insertion, actions and innervation of first interosseous

A

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
Q

What are the boundaries of the anatomical snuff box?

A

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
Q
A

Upper Limb Anatomy (3 decks)

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