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zAnatomy Exam 3 > UE: shoulder, bones, axilla and brachial plexus > Flashcards

UE: shoulder, bones, axilla and brachial plexus Flashcards

1
Q

bones

A

shoulder girdle: scapula and clavicle

upper extremity: humerus, radius and ulna, carpals, metacarpals, phalanges

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2
Q

Scapula

A

know theL

glenoid cavity

infraspinous and supraspinous and subscapular fossae

scapular spine

acromian process

coracoid prorcess

suprascapular notch

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3
Q

Scapula pic

A

be sure to understand for the unit … look at it from Exam 1 material

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4
Q

Describe the humerus parts

A

Head: attaches to glenoid cavity of scapula –

greater tubercle and lesser tubercle…intertubercular groove– biceps tendon

anatomical neck vs surgical neck

detoid tuberosity- deltoid attaches

condyles:

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5
Q

Humerus pic

A
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6
Q

tramau anatomical neck vs the surgical neck

A

any trauma applied to the humerus will like fracture at the surgical neck intead of the anatomical because it is much thinner

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7
Q

deltoid tuberosity

A

deltoid attaches here…. where deltoid inserts on the humerus and pulls on it

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8
Q

condyles

A

capitulum (lateral) –> radium

trochlea (medial) –> ulna

epicondlyes (lateral and medial)

coronoid fossa- anterior

olecranon fossa-posterior

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9
Q

sternoclavicular

A

should joints

between clavicle and manubrium, only attachment between UE and axial skeleton

stabilized by ligaments… not a ton of movement

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10
Q

acromioclavicular

A

between acromion of scapula and clavicle

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11
Q

glenohumeral

A

ball and socket joint between head of humerus and glenoid cavity

glenoid cavity is lined by catilaginous glenoid labrum– joint is supported by ligaments, rotator cuff muscles, and bursae (both continuous and separated from joint capsule)

flexion, extension, abduction, adduction, medial/lateral rotation, circumduction …..

glenoid labrum with cup shape that allows for the head of humerous to plug into something

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12
Q

bones of the forearm

A

radius and ulna

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13
Q

radius

A

lateral forearm bone, thumb side

Head= capitulum

radial tuberosity

styloid process

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14
Q

radial tuberosity

A

bicep muscle will attach… movement of the radius are different than movement of the ulna….

radius is able to pivot

The proximal end the radius is small and the ulna is kind of big… at the distal end, the radius is large and the ulna is small…

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15
Q

ulna

A

medial forearm bone, pinky side

Trochlear notch

olecranon process –> olecranon fossa

coronoid process –> coronoid fossa

syloid process (looks like a pen)… these ends are where the wrist joint is going to form between the carpals and distal radius

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16
Q

interosseous membrane

A

ligament that hold the radius and ulna together in between… helps to divide them into anterior and posterior muscle

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17
Q

pivoting of the forearm

A

pivoting around the elbow… allows for flexion & extension and pronation & supination

radius is not locked in place so it can pivot

radius freely rotate along the capitulum (pivot joint) to allow for the frearm pronation and supination… in the pronated position the ulna and radius are crossed

radius and ulna attached to each other at distal and proximal ends

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18
Q

3 joints of the elbow

A
  1. TRochlear notch of ulna and trochlea of humerus
  2. head of radius and capitulum of humerus
  3. head of radius and radial notch of the ulna
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19
Q

what joint allows for supination/pronation (pivot)

A

proximal radio-ulna joint

so head of radium and radial notch of the ulna

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20
Q

what joints all for flexion and extension?

A

trachlear notch of ulna and trohclea of humerus

head of radius and capitulum of humerus

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21
Q

anular ligament

A

ligaments that support the elbow joint that wraps around the radial head

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22
Q

describe the hand bones

A

Carpals: (scaphoid, lunate, triquetrum, pisiform) *trapezium, trapezoid, capitate, hamate

metacarpals (5 on each hand

Phalanges: proximal, middle, distal (except thumb-proximal and distal only

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23
Q

Carpal arch

A

capals form an arch… covered by the flexor retinaculum… tissue makes the carpal tunnel

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24
Q

carpal bones arrangement

A
  • *Thumb side — scaphoid, lunate, triquetrum and pisiform**
  • (piriformis is a sesamoind bone = a bone embedded in a tendon…not attached to other bone … wrapped about a tendon)*
  • *Next row… trapezium, trapezoid, capitate, and hamate**
  • Hamate has a hook*
  • TRapezium is for the thumb.. forms the attachment between the carpals and the metacarpals of the thumbs… special joint= saddle joints… make opposable thumbs*

Some lovers try position that they can’t handle

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25
Q

Wrist joints and joints in the hand

A
  • wrist joints (radius and ulna– with articular disc- wiht scaphoid, lunate and triquetrum of the carpals
  • capals joints; carpal have joints between themselves
  • carpometacarpal joints– the saddle joint between the first metacarpals and the trapezium allow for special movement of the thumb
  • metacarpophalangeal joint (MCP)– betwen metacarpals and proximal phalanges
  • interphalangeal joints: proximal (PIP) and distal (DIP)
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26
Q

back muscle

A
  • Latissimus dorsi: originated on the spine and inserted onto the front of humerus… adduction, extension and medial rotation
  • Trapezius: originate on the spine and the head and inserted on the side of the shouldner on the spine of acromin…move shoulder up and down and retraction of scapula
  • Rhomboid major and minor: retract scapula
  • Pectoralis major and minor: starts on the sternum and inserts on the front of the humerous, does adduction and medial rotion and flexion
  • serratus anterior: protraction
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27
Q

deltoid

A

triangular muscle from scapula and clavicle to humerus at the deltoid tuberosity

action: arm abduction (beyond supraspinatus motion)
innervation: axillary nerve

But can’t initiate abduction… it can’t do the first 15 degrees, it has to be helped first (by the supraspinatus) and then does the rest of abduction

Ex. Flu shot in the deltoid… if you feel sore when you continue to abduct past 15 degree and then deltoid takes over for the rest of it

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28
Q

Which one doens’t get innervation from the brachial plexus?

A

The trapezius is innervated by a spinal accessory nerve…cranial nerve that come from the head

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29
Q

what are the muscles over the scapula

A
  1. infraspinatus
    • originates on the infraspinatus fossa and inserts on the humerus
    • allows humerus to rotate laterally
    • innervation is from the suprascapular nerve off the bracial plexus
  2. supraspinatus
    • originates on the supraspinatus fossa and inserts on the humerus
    • abducts the humerus–does the first 15 degrees
    • innervation is from the suprascapular nerve off the bracial plexus
30
Q
A
31
Q

muscles over the scapula

A

posterior side: teres major and minor

minor superior to major

action: minor= lateral rotation fo the arm

major= same as lat dorsi, same insertion….medial rotation, extension, adduction

innervation:

minor: axi

32
Q

teres major

A

action: same as lat dorsi.. same inserton
- medial rotation, extension, adduction
innervation: lower subscapular nerve

origin is is the infraspinatus fossa but insertion front of humerus…allows adduction. medial rotatio nand extension

33
Q

teres minor

A

next to infrapinatus

minor: lateral rotation of the arm
innervation: axillary nerve

34
Q

muscle over the scapula: subscapularis

A

in the subscapular fossa on the anterior side of the scapula

medial rotation of the arm

innervated by the subscapular nerve

35
Q

Latissimus dorsi

A

between the two majors: between the pec major and teres major…..the la-di between the two majors

36
Q

muscles associated with the scapula

chart

A

stars mean it’s part of the rotator cup muscle…

37
Q

Blood supply to the axilla

A

axillary artery comes from the subclavan artery.. up through thoracic inlet over rib 1,

curve around rib 1 under the clavical and go into axilla and change name to the axillary artery

Axillary vein becomes subclavian vein goin in the opposite direction

38
Q

important structures that pass from the neck to the upper extremety

A

bracial plexus here comes from the neck and goes through the opening of the axilla and go down to the upper limb and innervates all the muscles that are in the upper limb and move the upper limb and the muscles in the back

39
Q

Brachial pl

A
40
Q

describe the axilla boundaries

A

inlet

anterior wall

medial wall

lateral wall

posterior wall

floor

41
Q

describe the inlet of the axilla boundaries

A

defined by bone

clavicle- anterior

scrapula-posterir

rib 1- medial

42
Q

describe the anterior wall of the axilla boundaries

A

clavipectoral fascia (subclavious and pectoralis minor)

pectoralis major

43
Q

describe the medial wall of the axilla boundaries

A

toracic wall and serratus anterior

ribs and the serrated muscle

44
Q

describe the later wall of the of the axilla boundaries

A

humerus

45
Q

describe the posterior wall of the axilla boundaries

A

muscle over the scapula and triceps muscle

46
Q

describe the floor of the axilla boundaries

A

lateral to the floor the axilla is continuous with the anterior compartment of the arm

47
Q

overall picture of the axilla boundary

A
48
Q

axillary artery

A
  • the right subclavial artery passes under the clavical and lateral to rib 1==> becomes axillary artery
49
Q

tell me about the divisions of the axillary arteyr

A
  1. proximal to pectoralis minor
    • superior thoracic
  2. posteiror to pec minor
    • thoraco-acromial
    • lateral thoracic
  3. distal to pec minor
    • subscapular
    • anterior and posteral cicumflex humeral (go around humerous and meet in the middle)

the axillary artery continues as the brachial artery in the arm

50
Q

the brachial artery

A

as the axillary artery passes the borader of teres major, it becomes the brachial arty…..travels down the front of the arm…anterir compartment near the elbow it divides into the radial and ulna arteries

has to give a branch to supply the back of the arm (profunda brachii) which supplies the posterior arm… runs with the radial nerve

used for blood pressure measurements

note that the branches of the bracial artery suppy the elbow in addition to other branches

51
Q

axillary viens

A

axillary vein accompanies the axillary artery and becomes subclavian vein after passing rib 1 – deep veins are the bracial vein that accompany the brachial artery–

Cephalic vein drains posterior later side of UE and passes in the deltopectoral groove between the deltoid and pectoralis major muscle before it enter the axillary vein

small brachial veins accompany brachial arty, but superfical structures are drained by cephalic (lateral) and basilic (medial veins)

veins originate near the hand and travel up the forearm.. cephalic vein and basilic vein make up most of the axillary artery

52
Q

axillary nodes

A

present in the axilla region… have many different groups that drain different things…

Drains the UE and parts of the upper back, shoulders, neck and most of breast

divided into groups based on location in the axilla

all drain up to the top of the axilla and drain up to the neck… all lymph ends up at the junction subclavian and internal jugular

53
Q
A
54
Q

Bracial Plexus

A

complex collection of nerves from the spinal cord traveling through the neck and axilla to innervate muscles and skin in the UE… formed from anterior (ventral) rami of C5-T1 spnal segments

divides ito prximal to distal:

roots

trunks

divisions

cords

55
Q

brachial plexus… more info just read

A

comes from cervical outflow.. C5-T1 … starts in the neck and travels to the upper limbs into the axillary inlet between the clavical and scapula and the first rib and then go through the axilla and then through the axilla and then it’s going to branc and give different branches that are going to supply all the muscle in the upper limb that move the upper limb in the upper limb but also on the chest wall and that in the upper back expect for trapezius which gets the spinal accessory nerve

56
Q

Brachial plexus.. cords and roots

A

roots: C5 -T1.. exit from the spinal cord and contributes to the brachial plexus or anterir rami of the 5 outflow segmens that make the roots…
trunk: superior, middle, inferior … passes from neck to axilla
division: anterior and posterior … post (supply the posterior compartments), ant (medial and lateral cords)
cords: lateral, posterior, medial

most major nerves of the UE branch off the cords

57
Q

Nerves of the brachial plexus

A

Nerves off the roots= dorsal scapular and long thoracic

nerve off of the trunks= supracscapular and nerve to subclavious

tthere are no nerves off the divisions

58
Q

long thoracic nerve

A

off the roots… from multples of these and travels on the throacic wall and innervates serratus anterior

59
Q

dorsal scapular

A

nerve off the roots

innervates the rhombids

60
Q

nerve to subclavious

A

under clavical…

61
Q

suprascapular nerve

A

no direct branches from the division

in trunk have inforior and superior … which does anterior side of scapula and the lower one does the terese major

62
Q

lateral cord

A

lateral pectoral nerve that innervates the pectoralis major…from the lateral cord we have the terminal nerve so the musculocutanous cord comes from the lateral cord

lateral cord contributes to 1/2 of the innervation to the median nerve

63
Q

medial cord

A

has medial pectoral nerve… innervate pec major and minor

has 2 cutaneous nerve (sensory for skin) … medial cutaneous of the arm and medial cutaneous of the forearm .. medial side of arm and foreamr contributes the ulna nerve and 1/2 median nerve

64
Q

posterior cord

A

gives axillary nerve to innervate the deltoid and teres minor so the axillary nerve is going to travel to the back of the scapula where teres minor is located and then we have tthe thoracordosl never to innervate the lats in the back

65
Q
A
66
Q

nerves off of the cords

A
  • lateral:
    • lateral pectoral
    • musculocutaneous
    • median
  • posterior
    • thoracodorsal
    • superior and inferior subscapular
    • axillary
    • radial
  • ​Medial
    • ​median
    • ​medial pectoral
    • medial cutaneous nerves ofthe arm and forearm
    • ulnar
67
Q

chart

A
68
Q

identifying the braches

A

axillary runs between the anterior and poseterior division of the brachial plexus

Find the M of the bracial plexus

from lateral to medial:

Musculocutanous, median , ulna

posterior cord behind axillary artery… radial nerve

69
Q

cutaneous innervation of the upper limb

A
70
Q
A

zAnatomy Exam 3 (3 decks)

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