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Extremities (2) > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

OR: Clavicle, Sturnum, Costal cartilages, external oblique aponeurosis
IN: Lateral lip of the intertubercular groove of humerous
NS: Medial and lateral pectoral nerves
AC: Flexion, adduction, and medial rotation of the arm

A

Pectoralis Major

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2
Q

OR: 3rd, 4th and 5th ribs
IN: Scapula (Coracoid process)
NS: Medial pectoral nerve
AC: Pulls the shoulder downward and forward; elevates the ribs

A

Pectoralis minor

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3
Q

OR: First costal cartilage
IN: Clavicle (Inferior surface)
NS: Nerve to subclavius
AC: Depresses the clavicle, stabilizes the sternoclavicular joint

A

Subclavius

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4
Q

A sheet of fibrous tissue that envelopes the body beneath the skin and/or encloses muscles and groups of muscles

A

Fascia

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5
Q

Fascia that invests the pectoral muscle and is continuous with the abdominal wall fascia.

A

Pectoral fascia

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6
Q

Fascia that forms the axilla. The pectoral fascia and clavipectoral fascia leave join laterally to form this

A

Axillary fascia

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7
Q

Fascia that descends from the clavicle to surround the subclavian muscle and pectoralis minor

A

Clavipectoral fascia

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8
Q

The lower clavipectoral fascia forms this part of the axilla. It pulls the axillary fascia taught when the UE is abducted.

A

Suspensory ligament

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9
Q

Fascia that invests each muscle originating from the surface of the scapula, creating a tough fascia compartment.

A

Scapular fascia

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10
Q

Fascia that surrounds the arm and attaches inferiorly to the epicondyle and olecranon.

A

Brachial fascia

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11
Q

What extends to the medial and lateral surface of the humerus, and separates the arm into the anterior (flexor) and posterior (extensor) compartments?

A

Medial and lateral intermuscular septa

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12
Q

What isolates an anterior and posterior compartment in the forearm? (3 answers)

A

Antebrachial fascia
Interosseous membrane
Lateral intermuscular septa

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13
Q

Causes of compartment syndrome (4 answers)

A

An injury or procedure which causes bleeding or edema within the compartment
A muscle tear which also causes bleeding
Over use injury which also causes swelling
Inappropriate casting/splinting (too tight)

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14
Q

Symptoms of compartment syndrome

A

Pain, weakness, swelling

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15
Q

Intervention of compartment syndrom

A

RICE, or more severe cases my require fasciotomy to avoid myonecrosis.

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16
Q 
Innervation landmarks
Deltoid: 
Thumb: 
3rd digit:
5th digit:
A

C5
C6
C7
C8

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17
Q

Superficial and deep veins communicate via:

A

Perforating veins

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18
Q

Veins begin in the ___ ____ ____ of the hand

A

dorsal venous plexus

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19
Q

Vein that forms on the radial side of venous plexus and courses proximal on the lateral arm crossing the arm to the delta-pectoral groove.

A

Cephalic vein

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20
Q

The cephalic vein pierces the _______ fascia to join the ______ vein.

A

Clavipectoral

Axillary

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21
Q

Vein the begins on the ulnar side of the venous plexus. Courses on the medial aspect of the forearm and arm piercing the brachial vein and form the axillary vein

A

Basilic vein

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22
Q

This vein crosses the antebrachial fossa to communicate between the cephalic and basilic veins

A

Medial cubital vein

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23
Q

Lymphatic nodes of the upper limb (4)

A

Cubital
Humeral
Subscapular
Axillary

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24
Q

Causes of lymphedema (4)

A

Breast cancer
Trauma
Infection
Decreased mobility

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25
Q

3 groups of shoulder muscles:

A

Anterior axioappendicular muscles
Posterior axioappendicular muscles
Scapulohumeral muscles

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26
Q

Group of 4 muscles that move the pectoral girdle. Name the muscles

A

Anterior axioappendicular muscles

pectoralis major
Pectoralis minor
Subclavius
Serratus anterior

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27
Q

Group of muscles that attach the upper limb to the skeleton of the trunk

A

Posterior axioappendicular muscles

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28
Q

Group of muscles (6) that act of the glenohumeral joint

A

Scapulohumeral muscles

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29
Q

OR: External surface of lateral 1st-8th/9th ribs
INS: Anterior surface of the medial border of the scapula
INN: Long thoracic nerve
AC: Strong protractor of the scapula. Rotates scapula to elevate glenoid fossa. Stabilized scapula so other muscles can act on UE.

A

Serratus anterior

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30
Q

Results of long thoracic nerve injury:

A

Winging and inability to raise arm past horizontal, due to inability to rotate the glenoid.

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31
Q

Upper extremity bones

A 
Clavicle
Scapula
Humerus
Ulna
Radius
Carpals
Metacarpals
Phalanges
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32
Q

Bone than ossifies before any other bone in the body

A

Clavicle

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33
Q

Bones in the pectoral girdle

A

Clavicle

Scapula

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34
Q

Bones in the free upper limb

A 
Humerus
Radius
Ulna
Carpals (8)
Metacarpals (5)
Phalanges (14)
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35
Q

Bone that connects the UP appendicular skeleton to the axial skeleton

A

Clavicle

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36
Q

Sternal (medial) end of the clavicle articulates with ____ at _____ joint

A

Manubrium

Sternoclavicular

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37
Q

Acromial (lateral) end of the clavicle articulates with the acromion of the ______ at the ______ joint.

A

Scapula

Acromioclavicular

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38
Q

Only joint holding the UE to the axial skeleton

A

Sternoclavicular joint

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39
Q

Which side of the clavicle would be thicker on a right handed person?

A

The right clavicle

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40
Q

Anterior surface of the scapula:

A

Subscapular fossa

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41
Q

What is the greater scapular notch formed by?

A

Lateral extension of the acromion

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42
Q

Attachment of inferior part of the middle trapezius

A

Deltoid tubercle

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43
Q

Shallow, concave oval fossa for articulation of the humeral head

A

Glenoid cavity

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44
Q

Stout, beak-like process superior to the glenoid fossa

A

Coracoid process

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45
Q

What does the thickened lateral angle on the scapula support?

A

The scapular head which supports the glenoid fossa

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46
Q

Where does the humerus articulate?

A 
Glenohemeral joint (scapula)
Elbow joint (radius and ulna)
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47
Q

Where on the humerus allows maximum ROM?

A

Spherical head on the proximal end

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48
Q

Humerus anatomical neck is separated from the head by the _____ ___

A

Sucapital groove

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49
Q

End of the humerus where greater and lesser tubercles are located, distal extensions of tubercles forming crests, intertubercular groove for the tendon of the long head of biceps

A

Proximal end

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50
Q

Area of humerus where deltoid tuberosity is located, as well as radial (spiral) groove for the radial nerve and artery

A

Shaft

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51
Q

Area of the humerus that articulates with the ulna

A

Trochlea

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52
Q

Area of the humerus that articulates with the radius

A

Capitulum

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53
Q

What accommodates the olecranon of the ulna (full extension) on the humerus?

A

Olecranon fossa

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54
Q

What on the humerus accommodates the head of the radius (full flexion)

A

Radial fossa

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55
Q

Area of the humerus that accommodates the coronoid process of the ulna (full flexion)

A

Coronoid fossa

56
Q

Medial condyle is for the ____ attachment

Lateral condyle is for the _____ attachment

A

Flexor

Extensor

57
Q

Most common site of fracture on the humerus

A

Surgical neck

58
Q

Where do proximal fractures of the humerus occur?

A

Surgical neck

59
Q

Key concern of humerus fractures

A

Neurovascular status

60
Q 
Fractures of humerus- name the associated nerves
Surgical neck:
Radial groove: 
Distal end: 
Medial epicondyle:
A

Axillary nerve
Radial nerve
Median nerve
Ulnar nerve

61
Q

Area there the biceps brachial tendon inserts

A

Radial tuberosity

62
Q

Which styloid process is longer and larger than the other by approx. 1cm distal?

A

Radial styloid process

63
Q

Only the distal ______ articulates with the carpal bones. Name which bones

A

Radius

Scaphoid and lunate

64
Q

Massive proximal end of the ulna articulates with the: (2 answers)

A

Trochlea and head of radius

65
Q

____ serves as a short, stout lever arm for extension in the ulna

A

Olecranon

66
Q

These 2 form the trochlear notch

A

Coronoid process and olecranon process

67
Q

Muscle that attaches to the tuberosity of the ulna

A

Brachialis muscle

68
Q

Oblique cord proximal to neurovascular hiatus. Transverse the space between the radius and ulna

A

Interosseous membrane

69
Q

Purpose of interosseous membrane

A

Acts to transmit force from the hand to the humerus

70
Q

Most common site for radius fracture

A

Middle third

71
Q

Type of fracture that is a transverse fracture of the distal radius.
Usually from forced dorsalflexion of the hand.
Usually an associated ulnar styloid avulsion fracture
Also known as the dinner fork deformity

A

Colle’s fracture

72
Q

Fracture where there is a ventral displacement

A

Smith’s fracture

73
Q

Isolated fracture of the radial styloid

Can result from forced ulnar deviation and supination of the wrist

A

Chauffeur’s fracture

74
Q

Chauffer’s fracture is typically caused by:

A

Compression of the scaphoid bone of the hand against the styloid process of the distal radius

75
Q

Name of carpal bones

A 
Scaphoid
Lunate
Triquitrum
Pisoform
Trapezium
Trapezoid
Capitate
Hamate
76
Q

What does the triquetrum articulate with?

A

The disc of the radioulnar joint

77
Q

Fracture most commonly associated from a fall on an open palm

A

Scaphoid fracture

78
Q

Fracture associated with injury to the distal ulnar nerve and artery

A

Hamate

79
Q

X-ray should be repeated ______ weeks later to confirm scaphoid fracture. Will see _____ ____ .

A

2

Bone growth

80
Q

Types of bones in the hand

A 
Carpals
Metacarpals
Proximal phalanges
Intermediate phalanges
Distal phalanges
81
Q

Origin, insertion, innervation action of TRAPS

A

OR: Medial 1/2 of superior nuchal line, external occipital protuberance, nuchal ligament, spinous sprockets of C7-T12
IN: Spine of scapula, acromion, lateral 1/3 of clavicle
NS: Cranial new XI (spinal accessory), C3-C4
AC: Superior- Elevates and rotates scapula
Middle: Retracts scapula
Inf- Depresses and rotates

82
Q

OR, INS, NS, AC or Levator scap

A 
OR: TVP of C1-C4
INS: Sup. Medial scapula
NS: Dorsal scapular nerve, C3-C4
AC: Elevates scapula
Assists in downward rotation of scapula
Bilaterally extends neck
Unilateral action flexes neck
83
Q

OR INS NS AC of Rhomboid major and minor

A

OR: Major- SP of T2-T5
Minor- SP of C7-T1
INS: Maj- Medial border of scapula below the spine
Min- Medial scapula, root of spine
NS: Dorsal scapular nerve
AC: Rectrats scapula, rotates glenoid tubercle down, fixes scapula against thoracic wall

84
Q

Test of rhomboids

A

Place hands post. On hips and push elbows back against resistance.

85
Q

Muscles that serve to position and fix the base o the UE so the limb can function

A

Post. Axioappendicular muscles

86
Q

Post. Axioappendicular muscles function in antagonistis and synergistic groups to position the:

A

Scapuloclavicular unit

87
Q

Independent innervation of synergistic groups in post. Axioappendicular muscles results in:

A

Little diminution of function in the face of an isolated nerve injury

88
Q

Exception of post. Axioappendicular muscles:

A

Superior trapezius by CN XI- upward rotation of the lateral angle of the scapula

89
Q

OR, INS, NS, AC of Deltoid

A

OR: Lateral 1/3 of clavicle, acromion, spine of scapula
INS: Deltoid tuberosity
NS: Axillary nerve (Passes around the surgical neck of humerus and is at risk in fractures of this location, dislocations and traction injuries!**)
AC: Ant- flexes and medically rotates are
Middle: Abducts arm after first 15 degrees
Post- extends and laterally rotates arm
Resists inferior displacement of the humeral head from glenoid fossa

90
Q

Muscle that does FIRST 15 degrees of arm abduction

A

Supraspinous

91
Q

Test for deltoid:

A

Resist abduction at >15 degrees

92
Q

Muscle forms the post. Inferior border of the axilla

A

Teres major

93
Q

OR, INS, INN, AC of Teres major

A

OR: Post, inf. Angle of scapula
INS: Medial lip of the intertubercular groove of humerus
INN: Lower subscapular nerve
AC: Adducts arm, medically rotates arm

94
Q

Test for Teres Major

A

Palpation of muscle during abduction of the abducted arm

95
Q

Intrinsic shoulder muscles that form a musculotendinous cuff. There are 4 of these muscles

A

Rotator cuff muscles (scapulohumeral muscles)

96
Q

Muscles of the Rotator Cuff muscles (4)

A

Supraspinatus
Infraspinatus
Subscapularis
Teres minor

97
Q

Tonic contraction of the rotator cuff muscles help keep the _______ _____ in the _____ ______

A

Humeral head in the glenoid cavity

98
Q

OR, INS, NS, AC of supraspinatus

A

OR: supraspinus fossa
INS: Sup. Facet of the greater tubercle of humerus
NS: Suprascapular nerve
AC: Abducts arm first 15 degrees

99
Q

OR, INS, NS, AC of infraspinatus

A

OR: Infraspinus fossa
INS: Middle facet of greater tubercle of humerus
NS: Suprascapular nerve
AC: Lateral rotation of the arm

100
Q

Test of infraspinatus

A

Flex at the elbow, adductor arm and laterally rotate against resistance

101
Q

OR, INS, NS, AC of Teres minor

A

OR: Lateral border of scapula
INS: Inf. Facet of greater tubercle of humerus
NS: Axillary nerve
AC: Lateral rotation of the arm

102
Q

Teres minor is mostly hidden by the:

A

Deltoid

103
Q

T/F:

Muscles acting on the humerus move the scapula

A

False

104
Q

OR, INS, NS, AC of Subscapularis

A

OR: Subscapular fossa
INS: Lesser tubercle of humerus
NS: Upper subscapular nerve, Lower subscapular nerve
AC: Medial rotation of the arm

105
Q

Rotator cuff wear and tear is especially in the:

A

Supraspinatus

106
Q

Rotator cuff is most often found in:

A

Throwing athletes

Uneducated, ill-informed, weekend athletes, body builders, weight lifters who neglects the RCs.

107
Q

Stage 1 of RC injuries

A

Edema and hemorrhage, most common people younger than 15

108
Q

Stage 2 of RC injuries

A

Fibrosis and tendinitis, most common in people aged 25-40

109
Q

Stage 3 of RC injuries

A

Tears of cuff, most common in people over 50

110
Q

Truncated pyramidal space located medial and interior to the glenohumeral joint and superior to the axillary fascia located at the junction of the arm and thorax

A

Axilla

111
Q

Axilla serves as:

A

A passage way for neurovascular structures from the trunk to the upper extremity

112
Q

Axilla passageway is brotected by:

A

Musculofascial and boy structures

-the mobility of the upper extremity exposes the axilla and its contents to injury

113
Q

Axillary borders

A

Apex (roof)
Base (floor)
Four walls- 3 muscular and 1 bony

114
Q

AKA thoracic outlet

Serves as passageway between the neck and axilla

A

Cervicoaxillary canal

115
Q

The cervicoaxillary canal is bounded by:

A

Clavicle
1st rib
Scapula

116
Q

Cervicoaxillary canal conducts: (4)

A

Arteries
Nerves
Veins
Lymphatics to the upper extremity

117
Q

Base of axilla is formed by:

A

Skin, subcutaneous tissue and fascia extending from the upper extremity to the lower thorax

118
Q

Location of the base of axilla

A

Level of the 4th rib

119
Q

Depending on the position of the limb, the floor of the axilla is somewhat:

A

Mobile

120
Q

Axilla wall formed by the pect major and minor and the clavicopectoral fascia

A

Anterior wall

121
Q

Wall of axilla formed mainly by the scapula and subscapularis on the anterior surface, inferiorly by teres major and altissimo Doris

A

Posterior wall

122
Q

What is the medial wall of the axilla formed by?

A

Lateral thoracic wall (4th and 5th ribs) and serratus anterior

123
Q

What is the lateral wall of the axilla formed by?

A

(Bony wall) by the interbercular groove of the humerus

124
Q

Contents of the axilla

A 
Axillary sheath (nerve, artery, vein)
Lymphatics
125
Q

Connective tissue that wraps around the nerve artery and vein in the axilla

A

Axillary sheath

126
Q

Things packed into the axilla (16)

A 
Axillary sheath (Nerves, veins, artery)
Medial cord of brachial plexus
Post. Cord of brachial plexus
Long thoracic nerve
Serratus anterior
Subscapularis
Infraspinatus
Scapula
Deltoid
Lymph nodes
Head of humerus
Intertubercular groove
Biceps brachial
Coracobrachialis
Pectoralis major and minor
Lateral cord of brachial plexus
127
Q

Axillary artery is an extension of:

A

Subclavian artery as it passes the lateral border of the 1st rib

128
Q

Axillary changes to the:

A

Brachial artery at the interior border of the teres major

129
Q

Key to the axillary artery:- insertion point

A

Pectoralis minor

130
Q

3 parts divided by pectoralis minor- part 1

A

superior to pec minor, branch is the superior thoracic artery - supplies first 2 intercostal spaces

131
Q

Part two of axillary artery and its branches

A

Deep to pec minor

Branches:
Thoracoacromial trunk - then acromial, deltoid, pectoral, clavicular

Lateral thoracic artery: to serratus anterior, runs with long thoracic nerve

132
Q

Part 3 of axillary artery and its branches

A

Distal/inf to pec minor

Branches- Subscapular artery, splits into circumflex scapular artery and Thoracodorsal artery below that

Anterior humeral circumflex

Posterior humeral circumflex

133
Q

Collateral curculation around the scapula- slide 20 - review

A

3rd segment of axillary artery branches form periscapular collateral circulation system 2 distal subclavian branches

Occlusion of the axillary artery proximal to the subscapular artery or distal to the thyrocervical trunk- can be tolerated due to this anastomotic network

134
Q

Axillary vein lays:

A

Anteromedial to the artery

135
Q

Axillary vein is formed by

A

Union of the brachial vein and basicilic vein at the inf. Border of the teres major

136
Q

Axillary vein becomes

A

Subclavian vein at the inf border of the 1st rib

137
Q

Axillary lymph nodes in order

A

Humeral, subscapular and pectoral to:
Central
Apical
Supraclavicular

Extremities (2) (28 decks)

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