UE Myology and More Clinical boxes

Question 1

winging of the scapula is a result of?

what can’t you do with a winged scapula?

Answer 1

paralysis of serratus anterior m. (usually due to long thoracic N injury)

aBduct upper limb beyond horizontal position

Question 2

what are the rotator cuff muscles?
which jt do they offer stability to?
which muscle is most commonly injured?

Answer 2

• infraspinatous m., supraspinatous m., subscapularis m., teres minor m., (SITS)
• glenohumeral jt
• supraspinatous

Question 3

bicipital myotactic reflex

• where do you see it?
• if you don’t see it, what could be injured?

Answer 3

• when you strike thumb over bicipital tendon with reflex hammer, you should see tendon tighten and forearm flex
• if no reflex, could have musculocutaneous N or C5 and C6 anterior rami injury

Question 4

biceps tendinitis occurs due to?

popeye deformity occurs due to?

Answer 4

• from repetitive movement of long head of biceps through intertubercular groove –> susceptible to inflamm. (might hear crepitus too)
• popeye deformity: long head tendon dislocates from groove or seperates from supraglenoid tubercle –> balling of mid arm

Question 5

what are the three spaces on the posterior shoulder?

Answer 5

quadrangular space, triangular space, triangular interval

Question 6

triangular space

muscles?
arteries, veins?

Answer 6

M: teres minor m., teres major m., long head of triceps brachii m.

A & V: circumflex scapular A and V

Question 7

quadrangular space

muscles, arteries, veins, nerves?

Answer 7

M: teres minor m., teres major m., long and lateral heads of triceps brachii m.

A & V: posterior humeral circumflex A and V
N: axillary N

Question 8

triangular interval

muscles, arteries, veins, nerves?

Answer 8

M: teres major m., long and lateral heads of triceps brachii m.

A & V: deep brachial A and V
N: radial N

Question 9

elbow tendinitis/tennis elbow when?

lateral epicondylitis occurs when?

Answer 9

• superficial extensor ms of forearm are repetitively used –> pain over lateral epicondyle and down posterior forearm
• periosteum of lateral humeral epicondyle gets strained due to repeated extension and flexion of wrist

Question 10

anatomical snuff box

muscles, arteries, nerves?

Answer 10

M: abductor pollicis longus m., extensor pollicis brevis m., extensor pollicis longus m.

A: radial A (deep to tendon)
N: superficial radial N

Question 11

nerve, jt, muscle involved in thumb opposition?

injury to nerve results in?

Answer 11

• median N or recurrent branch of median N, carpometacarpal jt of thumb, opponens pollicis m
• can’t oppose thumb (usually due to injury to palm, even a superficial one)

Question 12

5 functional positions of hand?

Answer 12

1. power grip
2. hook grip
3. precision handling grip
4. pinching
5. position of rest (inactive position)

Question 13

why are rotator cuff muscles important?

Answer 13

keep humeral head in glenoid cavity and help you raise your arm

Question 14

what’s the extensor expansion/hood, mechanism of action, importance in hand function?

Answer 14

• extensor digitorum tendon flatten as they reach metacarpals and and become hood
• contraction of the extensor digitorum muscle tightens tendon which acts on hoods –> extends the fingers.

Question 15

retinacula of UE? how do they assist in muscular actions?

Answer 15

flexor retinaculum: connective tissue that forms roof of carpal tunnel, protects structures w/in

extensor retinaculum: holds tendons of extensor tendons in place

Question 16

supraspinatus impingement syndrome leads to what?

Answer 16

• tendonitis of supraspinatous muscle or bursa under acromion

Question 17

power grip, hook grip, and pinching require what type of muscles?

Answer 17

extrinsic (fleshy bellies distant from hand)

Question 18

precision handling grip, and position of rest require what type of muscles?

Answer 18

intrinsic (muscles closer to hand)

Question 19

what is region 1 of axillary A susceptible to? why?

Answer 19

• aneurysm in ppl who do fast repeated arm movements (baseball pitchers)
• compresses brachial plexus –> pain and loss of sensation

Question 20

where must you ligate for the arm to receive no blood?

Answer 20

distal to subscapular A bc no anastomoses past that point for arm

Question 21

what veins dump blood into axillary V?

Answer 21

basilic V and cephalic V

Question 22

what is the acupuncture V? why?

Answer 22

medial cubital V bc it’s superficial to bicipital aponeurosis, which protects structures under it

Question 23

what lymph nodes are frequently invaded by cancer cells?

Answer 23

axillary lymph nodes

*breast cancer usually spreads to axillary lymph nodes in armpits