The pectoral Girdle, Shoulder and Axilla and The Arm and Brachial plexus (MSK) Flashcards
What are the four regions of the Upper limb?
- The pectoral Girdle
2.The arm - The forearm
4.The hand
What does the Pectoral Girdle describe?
The clavicle, scapula and muscles attached to these bones
Where is the Arm? What is the main bone called?
Region between the shoulder and elbow joints
Humerus
Where is the forearm between? What are the two bones called? What muscular compartments does it contain?
Elbow and wrist joint
Radius and Ulna
Anterior and Posterior muscular compartments
Where is the hand located in terms of the wrist? What are the anterior and posterior parts of it called respectively?
Distal to the wrist
Palm- Anteriorly
Dorsum- Posteriorly
What joint is the shoulder joint? What type of joint is it? Between the Articulation between what?
Glenohumeral joint
Synovial ball and socket joint
Articulation of Scapula and Proximal humerus
What does the Elbow joint allow us to do? What type of joint is it? What is it formed by the articulation of?
Flexion and extension of forearm
Synovial hinge joint
Humerus with the Ulna and radius
What Joints allow Pronation and supination of the forearm and hand? What is the joint between?
Proximal and Distal Radioulnar joints
Radius and Ulnar
What is the wrist joint also known as? What is it formed between? What 4 movements does it allow?
Radiocarpal joint
Distal radius and two of the carpal bones
Flexion, extension, abduction and adduction
Name structures a-h
a- Scapula
b- Glenohumeral joint
c- Humerus
d-Elbow joint
e- Ulna
f- Radius
g-Carpal Bones
h- Metacarpals and Phalanges
What are the 5 movements of the Scapula?
- Protraction (Move anteriorly)
- Retraction (Move posteriorly)
- Elevation (Shrug)
4.Depression - Rotation
What are the 7 movements of the Shoulder joint?
- Flexion
- Extension
- Abduction
- Adduction
- Internal rotation
- External rotation
- Circumduction
What are two movements of the elbow joints?
Flexion and Extension
Two movements of the Radioulnar joints?
Pronation and Supination
WHat are four movements of the wrist joints?
Flexion, extension, abduction and adduction
What are the 4 movements of the finger and thumb?
Flexion, extension, adduction and abduction
What two bones does the clavicle articulate with respectively? What are the names of the joints?
Sternum and Acromion of Scapula
Sternoclavicular joint and Acromioclavicular joint
Name structures a-e
a- Sterno-clavicular joint
b- Manubrium
c- Proximal clavicle
d- Sternum
e- First rib
Name structures f-i
f-Acromion process of scapula
g-Acromio-clavicular joint
h-Distal clavicle
i-Humerus
Name structures a-d
a- Spine of scapula
b- Acromion process
c- Supraglenoid tubercle
d- Coracoid process
Name structures e-i
e- Glenoid fossa
f- Supraspinous fossa
g- Infraglenoid tubercle
h- Infraspinous fossa
i- Subscapular fossa
What part of the Scapular articulates with the Clavicle? What is this an extension of?
Acromion process
Extension of the spine of the scapula
What does the Scapula, Clavicle and attached muscles comprise?
Pectoral girdle
Which part of the Scapular articulated with the Proximal humerus? What is superior and inferior to it?
Glenoid fossa (Lateral aspect of scapula)
Supraglenoid and Infraglenoid tubercles
What part of the Humerus Articulates with the Glenoid fossa (of scapula)? What groove is immediately distal to it?
Head of Humerus
Anatomical neck immediately distal
Name structures a-d
a- Lateral Epicondyle
b- Medial epicondyle
c- Shaft
d- Surgical neck
Name structure e-h
e-Bicipital groove
f- Greater tubercle
g- Anatomical neck
h- Head
What are the lesser and greater tubercles of the Humerus important for? What is the surgical neck important for?
Muscle articulations
Thin- easily fractured
What is the protuberance called at the upper lateral aspect of the humeral shaft called? Why is it important? What is the groove called in the posterior aspect of the humeral shaft? What runs through it?
Deltoid tuberosity
Deltoid muscle attaches
Radial groove
Radial nerve
What is the key muscle involved in protraction of the Scapula?
Serratus anterior
Name muscles of the posterior pectoral girdle a-e
a- Rhomboid major
b- Rhomboid minor
c- Supraspinatus
d- Levator Scapulae
e- Splenius capitis
Name structures f-k
f- Trapezius
g- Spine of the Scapula
h- Deltoid
i- Infraspinatus
j- Teres major
k- Latissimus dorsi
What are the two large and superficial muscles of the Posterior Pectoral girdle?
Trapezius and Latissimus dorsi
What do all these muscles (in red) connect? Except which muscle? What does this muscle connect?
Scapula to the vertebral column
Latissimus dorsi
Humerus and vertebral column
What are the three deeper muscles that connect the Medial border of the Scapula to the Vertebra column?
Levator Scapulae
Rhomboid major
Rhomboid minor
What movements of the Scapula does the Trapezius cause? What do its upper, middle and lower parts cause the scapula to do?
Rotation
Upper- Elevation
Middle- Retraction
Lower- Depression
What does the Latissimus dorsi do to the Humerus?
Extends, adducts and medially rotates the humerus
What do the Levator scapular, Rhomboid major and Rhomboid minor do to the Scapula respectively?
Elevates (Levator scapulae)
Retracts ( Rhomboid major and minor)
Name a and b
a- Skull, cervical and thoracic vertebrae
b- Clavicle and scapula
Name c and d
c- Lower thoracic vertebrae
d- Humerus Proximal and anterior
Name e, f, g and h
e- Upper cervical vertebrae
f- Scapular- Medial border
g- C7 and T1 vertebrae
h- Scapula- Medial border
Name i and j
I- thoracic vertebrae
j- Scapula medial border
What plexus innervates most of the muscles of the posterior pectoral girdle? What nerves innervate the Trapezius and Latissimus dorsi muscles respectively?
Brachial plexus
Trapezius - Accessory
Latissimus dorsi- Thoracodorsal nerve ( Branch of the brachial plexus)
How would you describe the fit between the Head of the Humerus and the Glenoid fossa? Why is this important? What is a downside of this?
Poor fit as glenoid fossa is shallow
Allows extensive movement
Easily dislocated
What are the 6 muscles lie deep to the Posterior pectoral girdle muscles? What do they articulate together?
- Deltoid
- Suprapinatus
- Infraspinatus
- Subscapularis
- Teres minor
- Teres major
Scapula and humerus
Which nerve innervates the Deltoid? What are the three movements of the Deltoid?
Axillary nerve
Abduction of the shoulder joint (after 15 degrees), Flexion and extension of the shoulder (anterior and posterior fibres)
What shape is the delta muscle?
Triangular
What 4 muscles make up the Rotator cuff?
1.Supraspinatus
2.Infraspinatus
3. Teres minor
4. Subscapularis
fill in a1,2 and 4
a1- Abduction beyond 15 degrees
a2- Spine and acromion of the scapula and the clavicle
a3- Deltoid tuberosity
Fill in b1,2,3
b1- Internal rotation and abduction
b2- Posterior surface and Inferior part of lateral border
b3- Anterior humerus
Fill in c1,2,3
c1- First 15 degrees of abduction
c2- Supraspinous fossa
c3- Greater tubercle- superior facet
Fill in d1,2,3
d1- External rotation
d2- Infraspinous fossa
d3- Greater tubercle-middle facet
Fill in e1,2,3
e1- External rotation
e2- Lateral border
e3- Greater tubercle- Inferior facet
Fill in f1,2,3
f1- Internal Rotation
f2- Subscapular fossa
f3- Lesser tubercle
Name structures b,c,d
b- Infraspinatus
c- Teres major
d- Acromion of Scapula
Name structures e,f,g
e- Teres major
f- Subscapularis
g- Teres minor
How do the Rotator cuff muscles provide stability to the glenoid fossa and head of humerus?
Their tendons fuse with the capsule of the shoulder joint
What three structrues reinforce the stability of the shoulder?
1- Glenoid Labrum- Rim of fibrocartilage around the glenoid fossa
2- Ligaments reinforce capsule
3- Tendons of the biceps brachii
Fill in a and b (borders of axilla)
a- Pectoralis Major and minor
b- Serratus Anterior and Thoracic wall
Fill in c and d (Borders of Axillary wall)
c- Scapularis, teres major and latissimus dorsi
d- Proximal humerus
What borders the Apex and Base of the Axilla?
Apex- First rib, Clavicle and scapula
Base- Skin and fascia between thoracic wall and arm
Name structures a-f
a- Serratus Anterior
b- Latissimus Dorsi
c- Teres major
d- Humerus
e- Cephalic vein
f- Basillic vein
Name structures g-k
g- Median nerve
h- Axillary artery
i- Axillary vein
j- Roots of Brachial plexus
k- Clavicle
Name structures l-n
L- First rib
M- Pectoralis Major
N- Pectoralis Minor
How many groups of Lymph nodes are there in the axilla? What do they drain?
Five
Upper limb, breast, chest wall, Scapular region and abdominal wall
What is the Axillary artery a continuation of? When does it become the axillary artery?
Subclavian artery
Passes over the border of the first rib
Which nodes receive lymph from all other nodes in the axilla? Where is it located?
Apical nodes
Apex
When does the Axillary artery become the Brachial artery?
As it crosses the Inferior border of the Teres major
Name structures a,b,c
a- Lateral Epicondyle
b- Shaft
c- Medial Epicondyle
What is the axillary Vein formed from? What joins it? Where does it become the subclavian vein?
Brachial and Basilic vein
Cephalic vein joins it
Lateral border of the first rib
Name structures d,e,f,g
d- Capitellum
e- Trochlea
f- Coronoid fossa
g- Olecranon fossa
What do the trochlea and Capitellum articulate with respectively?
Trochlea- Trochlear notch of ulna
Capitellum- Head of radius
What separates the Anterior and Posterior components of the Humerus?
Intermuscular septa
What are the three muscles of the anterior arm? What muscle innervates all three of them?
Biceps brachii
Brachialis
Coracobrachialis
Musculocutaneous nerve
What are the two heads of the Proximal Bicep brachii called? What does each articulate with respectively?
Long and short head
Long head- Supraglenoid tubercle of scapula
Short head- Coracoid process of scapula
Which part of which head on the bicep brachii helps to stabilise the Shoulder joint?
Tendon of the Long head
What happens to the heads of the Bicep brachii as they move distally? What do they articulate with and via what?
Converge
Radial tuberosity via a common tendon
Two primary movements of the Bicep? What other movement is it capable of?
Flexor of elbow joint
Supinator of the forearm (when elbow is flexed)
2.Flexion of shoulder joint
Where does the Brachialis muscle lie? What is its main function?
Deep to the biceps brachii
Flexor of the elbow joint
What does the Brachialis attach to Proximally and Distally?
Proximal- Distal shaft of humerus
Distal- Ulna tuberosity
What does the Coracobrachialis articulate with proximally and distally? What is its function?
Coracoid process of scapula and Medial aspect of the middle part of humerus
Weak flexor of shoulder joint
What is the main muscle of the Posterior arm? What is it made up of and where do they all converge?
Triceps brachii
Three heads/ bellies
Converge via a common tendon to the olecranon of the ulna
Name structures a-e
a- Deltoid
b- Lateral head of triceps
c- Axillary nerve
d- Teres major
e- Long head of triceps
Name structures f-i
f- Medial head of triceps
g- Olecranon
h- Radial nerve
i- Lateral head of tricpes
Where do the Long and Lateral heads of the Triceps originate from respectively?
Long- Infraglenoid tubercle of scapula
Lateral- Posterior humerus- proximal to radial grooveW
Where does the Medal head of the Triceps originate from? Main two functions of the Triceps?
Posterior humerus- Distal to radial groove
Extension of the Shoulder and elbow joints
What nerve innervates al of the Triceps? What is it a major terminal branch of?
Radial nerve
Brachial plexus
Where does the Radial nerve run? Where is this structure inbetween?
Radial groove
Between the Medial and Lateral heads of the triceps
What is the Brachial plexus? type of innervation?
Network of nerves providing motor and sensory innervation to the upper limbs
What are the five segments of the Brachial plexus?
1.- Roots
2- Trunks
3- Divisions
4- Cords
5- Branches
Name Branches a-e of Brachial plexus
a- Musculocutaneous
b- Axillary
c- Median
d- Radial
e- Ulnar
Name cords f-h of brachial plexus
f- Lateral
g- Posterior
h- Medial
Name trunks i-K of the brachial plexus
i- Superior
j-Middle
k- Inferior
Name roots l-p of brachial plexus
l- C5
m-C6
n-C7
o-C8
p-T1
What are the Superior, Middle and Inferior Trunks of the Brachial Plexus formed by respectively?
Superior- C5&C6
Middle- C7
Inferior trunk- C8&T1
What forms the Lateral cord of the Brachial plexus?
Anterior divisions of the Superior and middle trunks
What forms the Posterior and Medial cords of the Brachial Plexus respectively?
Posterior cord- Posterior divisions of all trunks
Medial cord- Anterior division of the Inferior trunk
Where are the trunks and Cords found in the upper limb respectievly?
Trunks- neck
Cords- Second part of axillary artery
What does the Axillary nerve innervate (3)? What is it a branch of? What two two spinal nerves does it originate from?
Deltoid and Teres minor and Upper lateral arm
Posterior cord
C5,6
What does the Radial nerve innervate (2)? What is it a continuation of? What spinal nerves does it originate at?
Triceps and Posterior compartment of forearm
Continuation of Posterior cord and fibres from C5-T1
Where do the Axillary and Radial nerves run close to respectively?
Axillary- Surgical neck of humerus
Radial- Radial groove on the posterior surface of humerus
What does the Musculocutaneous (4)? Where does it arise from and what spinal nerves?
Biceps Brachii, Brachialis and Coracobrachiallis and Part of lateral forearm
Lateral cord & C5-C6
What two cords is the Median nerve a continuation of? What fibres does it contain?
Lateral and Medial cords
C6-T1 (can contain fibres from C5-T1)
What two things does the Median nerve provide motor innervation for? What does it provide sensory information for? Where is it at its most vulnerable?
Most of the Muscles of the anterior forearm and the thumb
Lateral aspect and palm of hand
Cubital fossa (Anterior aspect of the cubital fossa)
What is the Ulnar nerve a continuation of? Where does it contain fibres from?
Medial cord
C8-T1
What does the Ulnar nerve provide motor innervation for? What does it provide sensory innervation for? (1&1)
Small muscles in the hand
Skin over Medial aspect of hand and Medial digits
