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Upper extemity Flashcards

1
Q

Name the anterior parts of the scapula

A
  1. Acromion
  2. Coracoid process
  3. Supraglenoid tubercle
  4. Glenoid fossa
  5. Infraglenoid tubercle
  6. Inferior angle
  7. Subscapular fossa
  8. Superior fossa
  9. Scapular notch
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2
Q

Name the posterior parts of the scapula

A
  1. Scapular notch
  2. Supraspinous fossa
  3. Spine of scapula
  4. Infraspinous fossa
  5. Supraglenoid notch
  6. Acromion
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3
Q

Name parts of the clavicle

A
  1. Conocoid tubercle
  2. Acromial facet
  3. Sternal facet
  4. Trapezoid line
  5. Conoid tubercle
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4
Q

What part of the scapula divides it from the posterior side?

A

Spine of scapula

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5
Q

What rough area of the clavicle does muscles and ligaments attach to

A

The trapezoid line

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6
Q

What helps the clavicle connect to the sternum?

A

The articular disc

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7
Q

Name the three ligaments found in the rotator cuff?

A
  1. Coracoclavicular ligament
  2. Acromioclavicular ligament
  3. Coracoacromial ligament
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8
Q

Describe a type one shoulder joint separation?

A

Type one no rupture just the AC joint is hurt

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9
Q

Describe a type 2 shoulder joint separation

A

Type two has rupture off the AC joint only

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10
Q

Describe type three shoulder joint separation

A

Rupture of the AC joint and coracoclavicular joint

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11
Q

List the parts of the anterior humerus

A
  1. Greater Tubercle
  2. Lesser tubercle
  3. intertubercular sulcus
  4. Head of the humerus
  5. Crest of the greater tubercle
  6. Crest of the lesser tubercle
  7. Lateral supracondylar ridge
  8. Medial supracondylar ridge
  9. Lateral epicondyle
  10. Medial epicondyle
  11. Capitulum
  12. Trochlea
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12
Q

What attaches to the capitulum of the anterior humerus?

A

Radius

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13
Q

What attaches to the trochlea of the humerus?

A

ulna

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14
Q

List the parts of the posterior humerus

A
  1. Head
  2. Greater tubercle
  3. Anatomical neck of the humerus
  4. Surgical neck of the humerus
  5. Deltoid tuberosity
  6. Medial supracondylar ridge
  7. Lateral supracondylar ridge
  8. Medial epicondyle
  9. Lateral epicondyle
  10. Olecranon fossa
  11. Trochlea
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15
Q

What is the weak spot of the humerus that is located inside the joint capsule?

A

Anatomical neck of the humerus

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16
Q

What part of the humerus is prone to fracture?

A

Surgical neck of the humerus

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17
Q

What part of the humerus originates flexor muscles?

A

Medial epicondyle

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18
Q

What part of the humerus do extensor muscles originate from?

A

Lateral epicondyle

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19
Q

List the parts of the ulna

A
  1. Olecranon process
  2. Coronoid process
  3. Radial notch
  4. Ulnar tuberosity
  5. Head of the ulna
  6. Ulnar styloid process
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20
Q

What part of the ulna does the brachialis muscle insert to?

A

ulnar tuberosity

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21
Q

What part of our ulna can we palpate?

A

The olecranon process

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22
Q

List the parts of the radius

A
  1. Head of the radius
  2. Neck of the radius
  3. Radial tuberosity
  4. Ulnar notch
  5. Dorsal radial tubercle
  6. Radial styloid process
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23
Q

Name the three ligaments found in the elbow

A
  1. Radial collateral ligament
  2. Ulnar collateral ligament
  3. Anular ligament
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24
Q

What elbow ligament is involved in the nursemaids elbow?

A

The anular ligament

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25
Q

Name the palmar carpal bones

A
  1. Scaphoid “boat shaped”
  2. Trapezium
  3. Trapezoid
  4. Capitate
  5. Hamate
  6. Pisiform
  7. Triquetrum
  8. Lunate
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26
Q

Which palmar carpal bones have tubercles or hooks

A

Tubercle of trapezium
Hamulus (hook) of Hamate

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27
Q

Name the dorsal carpal bones

A
  1. Scaphoid (boat shaped)
  2. Trapezium
  3. Trapezoid
  4. Capitate
  5. Hamate
  6. Triquetrum
  7. Lunate
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28
Q

Name the three joints found in the hand

A
  1. Carpometacarpal joint
  2. Intercarpal joint
  3. Radiocarpal joint
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29
Q

Which joint found in the hand moves the most?

A

Radiocarpal joint

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30
Q

Which joint found in the hand moves the least?

A

Intercarpal joint

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31
Q

Do all fingers have a middle phalange?

A

all except the thumb

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32
Q

Name the three phalangeal joints

A
  1. Distal interphalangeal joint (DIP)
  2. Proximal interphalangeal joint (PIP)
  3. Metacarpophalangeal joint (MCP)
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33
Q

Where are the collateral ligaments of the phalanges located?

A

In between the phalangeal joints

Prevent the fingers to move side to side

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34
Q

Name the four types of ligaments found in the wrist

A
  1. Dorsal radiocarpal and intercarpal ligaments
  2. Radiocarpal collateral ligaments
  3. Ulnocarpal collateral ligament
  4. Dorsal radioulnar ligament
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35
Q

Where are the deep transverse metacarpal ligaments found?

A

Between the metacarpals

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36
Q

What are the Palmar plates found?

A

Between the phalanges

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37
Q

Name the three palmar ligaments of the wrist

A
  1. Palmar radiocarpal
  2. Ulnocarpal
  3. Intercarpal
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38
Q

Which ligament is found on the Palmar side of the hand that forms the roof of the carpal tunnel

A

Flexor retinaculum

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39
Q

Which carpal bone is prone to avascular necrosis?

A

The scaphoid bone

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40
Q

What type of deformity do the Colle’s fracture exhibit and what is fractured?

A

Dinner fork deformity

The distal head of the radius fracture

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41
Q

Name the palpable are landmarks of the upper extremity

A
  1. Superior angle of the scapula
  2. Spine of the scapula
  3. Acromion
  4. Greater tubercle of the humerus
  5. Inferior angle of the scapula
  6. Medial humeral epicondyle
  7. Lateral humeral epicondyle
  8. Head of the radius
  9. Olecranon
  10. Styloid process of the ulna
  11. Styloid process of the radius
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42
Q

Name three muscles of the back that are affected by the upper limb

A
  1. Trapezius
  2. Teres major
  3. Latissimus dorsi
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43
Q

Name the four muscles of the upper limb that relate to the scapula

A
  1. levator scapulae
  2. Rhomboid major and minor
  3. Serratus anterior
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44
Q

What is the proximal attachment, distal attachment and the major function of the levator scapulae

A
  • Proximal attachments: Transverse processes of
    upper cervical vertebrae
  • Distal attachment: Superior angle of scapula
    -Major function: Elevate scapula
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45
Q

What is the proximal attachment, distal attachment and the major function of the rhomboid major and minor

A
  • Proximal attachments: Lower cervical to upper
    thoracic spinous processes
  • Distal attachment: Medial border of scapula
  • Major function: Retract scapula
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46
Q

What is the proximal attachment, distal attachment and the major function of the serratus anterior

A
  • Proximal attachments: Lateral thoracic wall
  • Distal attachment: Medial border of scapula
  • Major functions: Protract and rotate scapula
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47
Q

Name three types of fibers of the deltoid muscle and their attachments

A
  • Proximal attachments
  • Anterior fibers: Distal clavicle
    -Middle fibers: Acromion
    -Posterior fibers: Spine of scapula
  • Distal attachment: Deltoid tuberosity
  • Major functions
    -Anterior fibers: flex arm at the shoulder
    -Middle fibers: abduct the arm at the shoulder
    -Posterior fibers: extend arm at the shoulder
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48
Q

Name the major functions of the fibers of the deltoid muscle

A

Major functions
* Anterior fibers: flex arm at the shoulder
* Middle fibers: abduct the arm at the shoulder
* Posterior fibers: extend arm at the shoulder

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49
Q

Name three muscles found in the posterior side of the scapula

A
  1. Supraspinatus
  2. Infraspinatus
  3. Teres minor
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50
Q

Name the two muscles found in the anterior side of the scapula

A
  1. Supraspinatus
  2. Subscapularis
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51
Q

Name the proximal attachment, distal attachment, and function of the supraspinatus muscle

A
  • Proximal attachment: Supraspinous fossa
  • Distal attachment: Greater tubercle
  • Function: Initiate abduction of arm
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52
Q

Name the proximal attachment, distal attachment, and function of the infraspinatus muscle

A
  • Proximal attachment: Infraspinous fossa
  • Distal attachment: Greater tubercle
  • Function: Lateral rotation of the arm
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53
Q

Name the proximal attachment, distal attachment, and function of the infraspinatus muscle

A
  • Proximal attachment: Lateral border of scapula
  • Distal attachment: Greater tubercle
  • Function: Lateral rotation of the arm
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54
Q

Name the proximal attachment, distal attachment, and function of the subscapularis muscle

A
  • Proximal attachment: Subscapular fossa
  • Distal attachment: Lesser tubercle
  • Function: Medially rotate the arm
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55
Q

List of rotator cuff muscles

A
  • Supraspinatus
  • Infraspinatus
  • Teres Minor
  • Subscapularis
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56
Q

What is the function of the rotator cuff muscles?

A

Stabilize humeral head within the glenoid fossa

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57
Q

Which muscle does a drop arm test for?

A

Supraspinatus muscle - most common to be injured

Abduct shoulders to 90 ̊ degrees and slowly lower.
If arm cannot sustain position against resistance,
test is positive for supraspinatus tear.

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58
Q

Which muscles does the Apley test for?

A
  • Scratch back from above (externally rotate arm) infraspinatus muscle
  • Scratch back from below (internally rotate arm) subscapularis muscle
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59
Q

What are bursae?

A

Bean shaped bags filled with synovial fluid, located at high friction places

  • Subacromial bursa
  • Subdeltoid bursa
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60
Q

What’s the two muscles involved in the adduction and flexing of the arm?

A

Pectoralis major and coracobrachialis

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61
Q

List the three parts of the pectoralis major

A
  1. Clavicular part
  2. Sternal part
  3. Costal part
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62
Q

List the proximal attachment, distal attachments and major function of pectoralis major

A
  • Proximal attachments: Proximal clavicle, sternum, costal cartilages
  • Distal attachment: Intertubercular sulcus
  • Major functions: Adduct and flex arm
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63
Q

List the proximal attachment, distal attachments and major function of coracobraquialis

A
  • Proximal attachments: Coracoid process of scapula
  • Distal attachment: Medial shaft of humerus
  • Functions: Flex and adduct the arm
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64
Q

Which two muscles work to stabilize the scapula?

A

Pectoralis minor and subclavius

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65
Q

List the proximal attachment, distal attachments and major function of pectoralis minor

A
  • Proximal attachments: Ribs 3-5
  • Distal attachment: Coracoid process of scapula
  • Major function: Stabilize scapula
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66
Q

List the proximal attachment, distal attachments and major function of subclavius

A
  • Proximal attachments: Rib 1
  • Distal attachment: Inferior surface of clavicle
  • Major function: Stabilize clavicle
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67
Q

Name three muscles located in the anterior compartment of the arm

A
  1. Biceps brachii
  2. Coracobrachialis
  3. Braquialis
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68
Q

Which muscle of the anterior arm has two heads

A

Biceps brachii has a long head and a short head

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69
Q

List of proximal attachment, distal attachments, and functions of the biceps brachii

A
  • Proximal attachments:
  • Long head: Supraglenoid tubercle of scapula
  • Short head: Corocoid process of scapula
  • Distal attachment: Radial head (biceps tendon) and biceps
    aponeurosis into forearm fascia
  • Major functions: Flex and supinate forearm
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70
Q

List of proximal attachment, distal attachments, and functions of the braquialis

A
  • Proximal attachment: Anterior surface of distal humerus
  • Distal attachment: Coronoid process of ulna
  • Major function: Flex forearm
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71
Q

List the two muscles in the posterior compartment of the arm

A

Triceps and anconeous

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72
Q

Which muscle of the arm has three heads

A

Triceps brachii has a long head, a lateral head and a medial head

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73
Q

List of proximal attachment, distal attachments, and functions of the triceps braquii

A
  • Proximal attachments:
  • Long head: Infraglenoid tubercle
  • Lateral head: Posterior lateral shaft of humerus
  • Medial head: Posterior medial shaft of humerus
  • Distal attachment: Olecranon process
  • Major function: Extend forearm
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74
Q

List of proximal attachment, distal attachments, and functions of the anconius

A
  • Proximal attachment: Lateral epicondyle of humerus
  • Distal attachment: Olecranon process
  • Functions: Extend forearm & stabilize elbow joint
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75
Q

Name the inflammation located at the elbow

A

Olecranon bursitis

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76
Q

Which side are extensors found

A

Posterior side

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76
Q

Which side are flexors found

A

Anterior side

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76
Q

Which side are radialis muscles found

A

On the radial (thumb) side

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77
Q

Which side are ulnaris muscles found

A

On the ulnar (little finger) side

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78
Q

What do the carpi muscles move?

A

Move the wrist and the entire hand

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79
Q

What do the digitorium muscles move?

A

Move the digits

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80
Q

What do the pollicis muscles move?

A

Move the thumb (1st digit)

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81
Q

What do the indicis muscles move?

A

Specifically move the index finger (2nd digit)

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82
Q

What do the digiti minimi muscles move?

A

Specifically move the little finger (5th digit)

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83
Q

Which muscle is an exception and works as a flexor which is found in the posterior compartment of the forearm

A

Brachioradialis

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84
Q

List the proximal attachments, distal attachments and major function of the braquioradialis

A
  • Proximal attachments: Lateral supracondylar ridge
  • Distal attachment: Distal radius
  • Major function: Flex forearm
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85
Q

List the proximal attachments, distal attachments and major function of the extensor carpi radialis longus and brevis

A
  • Proximal attachments: Lateral supracondylar ridge and lateral epicondyle
  • Distal attachments: Base of 2 nd and 3rd metacarpals
  • Function: Extension and radial deviation at the wrist
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86
Q

List the muscles of the superior layer of the posterior forearm

A
  1. braquioradialis
  2. Extendor carpi radialis longus
  3. Extensor carpi radialis brevis
  4. Extensor digitorium
  5. Extensor carpi ulnaris
  6. Extensor digiti minimi
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87
Q

List the proximal attachments, distal attachments and major function of the extensor digitorium

A
  • Proximal attachments: Lateral epicondyle
  • Distal attachment: Extensor expansion/hood of digits 2-5
  • Function: Extend digits 2-5 at MCP joints through extensor expansion
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88
Q

List the proximal attachments, distal attachments and major function of the extensor digiti minimi

A
  • Proximal attachments: Lateral epicondyle of humerus
  • Distal attachment: Extensor expansion/hood of digit 5
  • Function: Extend digit 5 at MCP joint
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89
Q

List the proximal attachments, distal attachments and major function of the extensor carpi ulnaris

A

*Proximal attachments: Lateral epicondyle of humerus
* Distal attachment: Base of 5th metacarpal
* Function: Extension and ulnar deviation at wrist

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90
Q

List the muscles of the deep layer from the posterior forearm

A
  1. Supinator Muscle
  2. Abductor pollicis longus
  3. Extensor pollicis longus
  4. Extensor pollicis brevis
  5. Extensor Indicis
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91
Q

List the proximal attachments, distal attachments and major function of the supinator muscle

A
  • Proximal attachments: Lateral epicondyle, proximal ulna
  • Distal attachment: Proximal anterolateral surface of radius
  • Function: Supinate forearm
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92
Q

List the proximal attachments, distal attachments and major function of the Abductor pollicis longus, extensor pollicis longus and brevis

A
  • Proximal attachments: Posterior radius, posterior ulna, & interosseous membrane
  • Distal attachment: Base of 1st metacarpal, proximal phalanx, and distal phalanx
  • Functions: Abduct & extend 1st digit at carpometacarpal joint. Extensor longus extends
    interphalangeal joint of 1st digit.
93
Q

List the proximal attachments, distal attachments and major function of the extensor indicis

A
  • Proximal attachments: Distal ulna & interosseous membrane
  • Distal attachment: Extensor expansion/hood of 2nd digit
  • Function: Extend 2nd digit / index finger
94
Q

Name the muscles from the superficial and intermediate layers of the anterior forearm

A
  1. Flexor Carpi Radialis
  2. Flexor Carpi Ulnaris
  3. Flexor Digitorium Superficialis
  4. Pronator teres
  5. Palmaris longus
95
Q

List the proximal attachments, distal attachments and major function of the Flexor carpi radialis

A
  • Proximal attachments: Medial epicondyle of humerus
  • Distal attachment: Base of 2nd metacarpal
  • Major functions: Flex and abduct hand (radial deviation) at wrist
96
Q

List the proximal attachments, distal attachments and major function of the flexor carpi ulnaris

A
  • Proximal attachments: Medial epicondyle of humerus
  • Distal attachment: Pisiform bone and hamate
  • Major functions: Flex and adduct hand (ulnar deviation) at the wrist
97
Q

List the proximal attachments, distal attachments and major function of the flexor digitorium superficialis

A
  • Proximal attachments: Medial epicondyle of humerus & proximal radius
  • Distal attachment: Middle phalanx of digits 2-5
  • Major function: Flex digits 2-5 at MCP & PIP joints
98
Q

List the proximal attachments, distal attachments and major function of the pronator teres

A
  • Proximal attachments: Medial epicondyle and coronoid process of ulna
  • Distal attachment: Lateral border of radius
  • Major function: Pronate forearm
99
Q

List the proximal attachments, distal attachments and major function of the palmaris longus

A
  • Proximal attachments: Medial epicondyle of humerus
  • Distal attachment: Palmar aponeurosis
  • Function: Weakly flex hand at wrist
100
Q

Name the muscles from the deep layer of the anterior forearm

A
  1. Flexor digitorium profundus
  2. Flexor pollicis longus
  3. Pronator quadratus
101
Q

List the proximal attachments, distal attachments and major function of the Flexor digitorum profundus

A
  • Proximal attachments: Anterior surface of ulna and interosseous membrane
  • Distal attachment: Distal phalanx of digits 2-5
  • Major function: Flex digits 2-5, especially the DIP joint
102
Q

Which deep muscle from anterior forearm goes all the way to the tip the phalanges?

A

Flexor digitorium profundus

103
Q

List the proximal attachments, distal attachments and major function of the Flexor pollicis longus

A
  • Proximal attachments: Anterior radius and interosseous membrane
  • Distal attachment: Distal phalanx of digit 1
  • Major function: Flex digit 1 at the interphalangeal joint
104
Q

List the proximal attachments, distal attachments and major function of the Pronator quadratus

A
  • Proximal attachments: Distal anterior ulna
  • Distal attachment: Distal anterior radius
  • Major function: Pronate forearm
105
Q

What is the common name of lateral epicondylitis?
Which deviation and movement of wrist is involved?

A

Tennis Elbow

Tenderness and pain on lateral
epicondyle, worsened by radial
deviation & extension of the wrist.

106
Q

What is the common name of medial epicondylitis?
Which deviation and movement of wrist is involved?

A

Golfer’s elbow

Tenderness and pain on medial
epicondyle, worsened by ulnar
deviation & flexion of the wrist.

107
Q

Which digit is involved with the hypothenar eminence?

A

The 5th phalange - pinky

108
Q

Which digit is involved with the thenar eminence?

A

The 1st phalange - thumb

109
Q

Name the 7 main muscles of the hand

A
  1. Abductor digit minimi
  2. Flexor digiti minimi
  3. Opponens digiti minimi
  4. Adductor pollicis
  5. Opponens pollicis
  6. Abductors pollicis brevis
  7. Flexor pollicis brevis
110
Q

Name the three muscles of the hypothenar eminence

A
  1. Abductor digiti minimi
  2. Opponens digiti minimi
  3. Flexor digiti minimi
111
Q

List the proximal attachments, distal attachments and major function of the Abductor digiti minimi

A
  • Proximal attachment: Anterior hamate
  • Distal attachment: Base of 5 th digit’s proximal phalanx
  • Major function: Abduct 5th digit
112
Q

List the proximal attachments, distal attachments and major function of the Opponens digiti minimi

A
  • Proximal attachment: Anterior hamate
  • Distal attachment: 5th metacarpal
  • Major function: Pull 5th digit anteriorly
113
Q

List the proximal attachments, distal attachments and major function of the flexor digiti minimi

A
  • Proximal attachment: Anterior hamate
  • Distal attachment: Base of 5 th digit’s proximal phalanx
  • Major function: Flex 5th digit at MCP joint
114
Q

Name the muscles from the thenar eminence

A
  1. Abductor Pollicis Brevis
  2. Flexor Pollicis Brevis
  3. Opponens pollicis
115
Q

Which muscle of the hand does not belong to either eminence?

A

Adductor pollicis

116
Q

List the proximal attachments, distal attachments and major function of the Abductor Pollicis Brevis & Flexor Pollicis Brevis?

A
  • Proximal attachments: Anterior surface of lateral carpals
  • Distal attachment: Base of proximal phalanx
  • Major function: Abduct and flex 1st digit
117
Q

List the proximal attachments, distal attachments and major function of the opponens pollicis?

A
  • Prox. attachment: Anterior surface of lateral carpals
  • Distal attachment: 1st metacarpal
  • Major function: Pull 1st digit anteriorly
118
Q

List the proximal attachments, distal attachments and major function of the Adductor Pollicis ?

A
  • Proximal attachment: Anterior surface of 2 nd and 3rd metacarpals
  • Distal attachment: Metacarpal & proximal phalanx of 1 st digit
  • Major function: Adduct 1st digit
119
Q

Name the 3 groups of muscles found in the hand?

A
  1. Lumbrical muscles (4)
  2. Palmar Interosseous Muscle (3)
  3. Dorsal Interosseous Muscles (4)
120
Q

List the proximal attachments, distal attachments and major function of the lumbrical muscles (4)

A
  • Proximal attachments: Tendons of flexor digitorum profundus
  • Distal attachment: Extensor expansion
  • Major function: Extend PIP and DIP joints
121
Q

List the proximal attachments, distal attachments and major function of the Palmar interosseous muscle (3)

A
  • Proximal attachments: Between 2nd - 5th metacarpal bones
  • Distal attachment: Extensor expansion
  • Major function: Adduct digits toward midline (3 rd digit)
122
Q

List the proximal attachments, distal attachments and major function of the Dorsal Interosseous muscles (4)

A
  • Proximal attachments: Between 1st – 5th metacarpal bones
  • Distal attachment: Extensor expansion
  • Major function: Abduct digits from midline (3 rd digit)
123
Q

What forms the extensor hood expansion

A

Tendons of the interossei and lumbricals join the extensor digitorum just
past the MCP joint.

124
Q

What allows the digital tendons to slide without causing irritation?

A

Tendons of the digital flexors travel in synovial sheathes that are covered by a fibrous
sheath. This allows the tendons to slide without causing irritation.

125
Q

Which flexor tendon sheath are partially within the carpal tunnel?

A

The common flexor sheath and the flexor pollicis longus sheath

126
Q

Which flexor tendon sheath are usually isolated from each other?

A

The flexor pollicis longus sheath and the tendon sheathes of digits 2-4

127
Q

Which 2 flexor tendon sheaths connect?

A

The synovial sheath of the 5th digit and the common flexor sheath

128
Q

Which spinal nerves are the major contributors to the innervation of the upper limb?

129
Q

Which spinal nerves are the minor contributors to the innervation of the upper limb?

130
Q

What is the tendency of innervation to the most proximal muscles of the upper limb?

A

To be innervated by more superior nerves

131
Q

What is the tendency of innervation to the most distal muscles of the upper limb?

A

To be innervated by more inferior nerves

132
Q

Sensory of upper limb by dermatome C4

A

Top of the shoulder

133
Q

Sensory of upper limb by dermatome C5

A

Lateral shoulder

134
Q

Sensory of upper limb by dermatome C6

A

1st digit - thumb

135
Q

Sensory of upper limb by dermatome C7

A

3rd digit - palmar side

136
Q

Sensory of upper limb by dermatome C8

137
Q

Sensory of upper limb by dermatome T1

A

Medial elbow

138
Q

What gives rise to the braquial plexus

A

Anterior rami

139
Q

What are the five parts of the braquial plexus?

A
  1. Roots (C5-T1)
  2. Trunks: Superior, Middle, Inferior
  3. Divisions: Anterior and posterior per trunk
  4. Cords: Lateral, medial, posterior
  5. Terminal branches
140
Q

Which spinal nerves make the superior trunk?

141
Q

Which spinal nerves make the middle trunk?

142
Q

Which spinal nerves make the inferior trunk?

143
Q

Which trunks makes the Lateral Cord?

A

The superior and middle trunks

144
Q

Which trunks makes the posterior Cord?

A

The superior, middle and inferior trunks

145
Q

What type of muscles are innervated by the posterior cord?

A

The flexors

146
Q

Which trunks makes the medial Cord?

A

The inferior trunk

147
Q

List the 5 terminal branches of the braquial plexus

A
  1. Musculocutaneous nerve: Lateral only
  2. Axillary nerve: Posterior only
  3. Radial Nerve: Posterior only
  4. Median Nerve: Posterior and medial
  5. Ulnar Nerve: Medial only
148
Q

What does the musculocutaneous nerve innervates?

A

All muscles in the anterior compartment of the arm

&

Sensory info for the lateral forearm

149
Q

What symptoms are exhibited when the musculocutaneous nerve is affected?

A

-Weakness inability to flex the forearm at elbow

-Altered sensation over the lateral forearm

150
Q

Which muscles does the axillary nerve innevrvates?

A
  • Deltoid
  • Teres minor
151
Q

Where does the axillary nerve carry sensory info to?

A

Lateral shoulder

152
Q

Which muscles does the radial nerve innervates?

A

Posterior arm and forearm

153
Q

Name the 3 divisions of the radial nerve

A
  1. Superficial radial nerve (sensory)
  2. Deep radial nerve (motor)
  3. Posterior interosseous nerve (motor)
154
Q

Where does the radial nerve carry sensory info to?

A

Posterior arm and forearm

155
Q

What signs are evidence of a proximal radial nerve lesion?

A

Weakness, or inability to extend the forearm at the elbow, extend the hand of the carpus and extend the fingers.

Altered sensation of her the posterior arm, forearm and hand

156
Q

What signs are evidence of a distal radial nerve lesion?

A

Intact, elbow movement, but weakness and inability when extending the wrist in fingers

Altered sensation over the posterior forearm and hand

157
Q

Which muscle king exhibit atrophy after the axillary nerve damage?

A

Deltoid muscle

158
Q

Which two nerves innervate the anterior compartment of the forearm and hand?

A
  1. Median nerve
  2. Ulnar nerve
159
Q

What does the median nerve innervates?

A

Nearly all the muscles in the FOREARM a few of the muscles of the hand

160
Q

What does the ulnar nerve innervates?

A

Innervates 1 1/2 muscles of the forearm and nearly all muscles of the HAND

161
Q

Which muscle says the median nerve innervates in the anterior forearm?

A
  1. Abductor pollicis brevis
  2. Opponens pollicis
  3. Flexor pollicis brevis
  4. 1st and 2nd lumbricals
162
Q

What are the two branches of the median nerve?

A
  1. Anterior interosseous nerve
  2. Recurrent branch of the median nerve (muscles of thenar eminence)
163
Q

Where does the median nerve carries sensory information?

A

From the palmar aspect of digits, 1-3 and radial half of the fourth digit

164
Q

Signs of median nerve damage

A
  1. Thenar eminence atrophy
  2. weakness in the motion of the 2nd digit = inability to make a circle with a thumb and index
  3. Weakness from the forearm muscles and inability to make a fist = hand of benediction
165
Q

What muscles does the ulnar nerve innervates?

A
  1. Flexor carpi ulnaris
  2. 1/2 a flexor digitorum profundus
166
Q

What are the two branches from the ulnar nerve?

A
  1. Deep branch: innervates all muscles of the hand that are not innervated by the median nerve
  2. Superficial branch: Carry sensory information from the palmar and dorsal aspects of the 5th digit and the ulnar 1/2 of the 4th digit
167
Q

Signs of ulnar nerve damage

A
  1. weakness in grip, particularly in abduction and adduction of the digits against resistance, affecting sensation as well
  2. Proximal nerve lesion percent weakness in wrist flexion, when asked to make a fist, patient will often described as having a “claw hand”
168
Q

Where do proper palmar digital nerves come from?

A

The common palmar digital nerves (come from median and ulnar)

169
Q

What do the proper palmar digital nerves give rise to?

A

The dorsal branch: goes to the fingertips and nail bed areas

170
Q

What is the only nerve that goes to the thenar eminence?

A

The recurrent branch of the median nerve

171
Q

Which nerve of the digits go through the carpal tunnel?

A

The median nerve

172
Q

Name the six proximal branches of the brachial plexus that come from the CORDS

A
  1. Subscapular nerve (posterior cord)
  2. Thoracodorsal nerve (posterior cord)
  3. Lateral pectoral nerve (lateral cord)
  4. Medial pectoral nerve (medial cord)
  5. Medial cutaneous nerve of the arm (medial cord)
  6. Medial cutaneous nerve of the forearm (medial cord)
173
Q

Which muscles does a subscapular nerve innervates?

A
  1. Subscapularis muscle: internal rotation of the arm
  2. Teres major muscle: arm adduction
174
Q

Signs of subscapular nerve lesion

A

Weakness in ability to internally rotate the arm

Patient may present with persistent, rotated, arm externally

175
Q

Which muscle does the thoracodorsal nerve innervates?

A

Latissimus dorsi: adduct and extend arm and shoulder

176
Q

Signs of thoracodorsal nerve lesion

A

Weakness and inability to “row” one’s arm back from a flexed or abducted position at the shoulder

177
Q

What muscles does the medial pectoral nerve innervates?

A
  1. Pectoralis major: adduct and flex arm shoulder
  2. Pectoralis minor: stabilize the scapula by pulling coracoid process, inferiorly and anteriorly
178
Q

What muscle does the lateral pectoral nerve innervates?

A

Pectoralis major

179
Q

Signs of pectoral nerve lesions

A

Weakness/inability to push away from a wall, or move the shoulder from an abducted position to flexed position

180
Q

What does posterior cord damage entail?

A

Lots of radial an axillary nerve function

181
Q

What does lateral cord damage entail?

A

Loss of musculocutaneous and weakness of median nerve

182
Q

What does medial cord damage entail?

A

Loss of ulnar nerve and weakness from median nerve.

Loss of sensation from medial arm and forearm

183
Q

What is the four nerves of the roots and trunks from the brachial plexus?

A
  1. Dorsal scapular nerve
  2. Long thoracic nerve
  3. Nerve to the subclavius
  4. Suprascapular nerve
184
Q

What does the dorsal scapular nerve innervates?

A
  1. Levator scapulae: elevation of the scapula
  2. Rhomboid major and minor: retraction of scapula

Lesion signs:
Weakness, elevating and retracting the scapula, trapezius stays functional and masks the problem

185
Q

What does the long thoracic nerve innervates?

A

Serratus anterior muscle: protraction and rotation of the scapula

Lesion signs: weakness/inability to protractor scapula. Scapula “wings” posteriorly when the person tries to push their body away from the wall or push up

186
Q

What does the nerve to the subclavius innervates?

A

Subclavius muscle: stabilizes the clavicle

187
Q

What does a suprascapular nerve innervates?

A
  1. Supraspinatus muscle: initiate of arm abduction
  2. Infraspinatus muscle: lateral rotation of the arm

Lesion signs: weakness/inability to initiate abduction of the arm at the shoulder and to externally rotate the arm at the shoulder

188
Q

Which trunk or roots are injured to cause the Erb-Duchenne palsy

A

Superior trunk or C-5 C6 roots of the brachial plexus

189
Q

Which trunk is affected by Klumpke’s paralysis?

A

Inferior trunk of brachial plexus.

Non-functional ulnar nerve and sensory loss from the middle cutaneous nerves of the arm and forearm

Claw hand appearance.

190
Q

Which artery is the parent artery to the entire limb?

A

The subclavian artery

191
Q

When does the subclavian artery becomes the axillary artery?

A

After it crosses the 1st rib

192
Q

Name the scapulary branches of the subclavian artery

A
  1. Dorsal scapular artery: levator scapulae, and rhomboid muscles
  2. Suprascapular artery: supraspinatus and infraspinatus
193
Q

List the three segments of the axillary artery

A
  1. Supreme thoracic artery - proximal to pectoralis minor
  2. Lateral thoracic artery, and thoracoacromial trunk - covered by pectoralis minor
  3. Subscapular artery, anterior humeral circumflex artery, posterior humeral circumflex artery - distal pectoralis minor
194
Q

Where does the supreme thoracic artery supply to?

A

Supplies the Anterior 1st and 2nd intercostal spaces

195
Q

Where does the lateral thoracic artery supply to?

A

The serratus anterior muscle and breast issues

196
Q

Where does a subscapular artery supply blood to?

A

The subscapularis

197
Q

How many branches does the subscapular artery have?

A

Two

  1. Circumflex scapular artery: supply the infraspinatus muscle
  2. Thoracodorsal artery: supply latissimus dorsi muscle
198
Q

Where do the anterior in posterior humeral circumflex artery supply blood to?

A

Supply the deltoid and anterior compartment of the arm

199
Q

When does the axillary artery become brachial artery?

A

As it crosses the teres major muscle

200
Q

Name the three parts of the brachial artery

A
  1. Deep brachial artery
  2. Superior ulnar collateral artery
  3. Inferior ulnar collateral artery
201
Q

Where does the deep brachial artery supply blood to?

A

Posterior compartment of the arm

202
Q

Where do the superior and inferior ulnar collateral arteries branch to?

A

Superior: branches medially near middle arm
Inferior: branches medially near elbow

203
Q

Name the 2 arteries the brachial artery give rise to at the cubital fossa

A

Radial and ulnar arteries

204
Q

What is the radial artery supply blood to?

A

The radial side of the anterior compartment of the forearm

205
Q

Which artery does the radial artery give rise to at the elbow?

A

The radial recurrent artery

206
Q

Where does the ulnar artery supply blood to?

A

Ulnar side of the anterior compartment of the arm

207
Q

Name the two branches of the ulnar artery

A
  1. Ulnar recurrent artery
  2. Common interosseous artery
208
Q

Name the two branches of the common interosseous artery

A
  1. Anterior interosseous artery: supply deep structures of the anterior forearm
  2. Posterior interosseous artery: supply posterior forearm
209
Q

What forms the superficial palmar arch?

A

The ulnar artery with variable contribution from the radial artery

210
Q

What does a superficial palmar arch give rise to?

A

Common Palmar digital arteries

–> then give rise to:

Proper palmar digital arteries (run side-side of the digits)

211
Q

Which palmar arch does the radial artery give rise to through the adductor pollicis muscle? (anteriorly)

A

Deep Palmar arch

–> then give rise to

Palmar metacarpal arteries –> join the common palmar digital arteries

212
Q

What can result of a fracture?

A

It can compromise nutrient arteries, and can result in avascular necrosis of the bone

It can be saved by collateral circulation from epiphyses

213
Q

Name 3 examples of anastomosis around the shoulder

A
  1. Axillary and subscapular artery
  2. Suprascapular and circumflex scapular artery
  3. Subscapular artery in circumflex scapular artery
214
Q

List the 3 anastomosis around the elbow

A
  1. Deep brachial and radial recurrent arteries
  2. Superior ulnar collateral and posterior ulnar recurrent artery
  3. Inferior ulnar collateral and anterior ulnar recurrent
215
Q

Anastomosis around the hand

216
Q

Which veins run parallel to arteries and share their names

A

Deep veins

217
Q

Name two large, superficial veins that have no corresponding artery

A
  1. Cephalic vein
  2. Basilic vein
218
Q

Which vein connects the cephalic and basilic veins at the cubital fossa

A

Median cubital vein

219
Q

What does the cephalic vein drain?

A

Radial hand, posterior for arm and arm

Empties into the subclavian vein

220
Q

What does the basilic vein drains?

A

The ulnar hand and anterior forearm

Drains to the brachial vein at the elbow

221
Q

List an example of a neurovascular bundle

A

The axillary artery closed connection with the cords of the brachial plexus

  • Passes through the quadrangular space
  • vulnerable during shoulder dislocation and humeral neck fracture
222
Q

Where does the radial nerve/deep brachial vessels bundle passes through and what is vulnerable to?

A

Passes through the triangular interval

Vulnerable to mid shaft humeral fractures

223
Q

Where does the ulnar nerves/ulnar vessels bundle passes through and what is vulnerable to?

A

In distal forearm and carpus only

Vulnerable during trauma/fracture, near the medial aspect of the distal forearm and carpus

224
Q

Where does the proper palmar digital nerve/proper palmar vessels bundle passes through and what is vulnerable to?

A

Vulnerable to laceration on the lateral palmar aspect of all digits

225
Q

What is the lymph?

A

Fluid between cells that accumulates cellular debris and other large junk proteins that may be too big to drain into capillaries or veins

226
Q

What are lymphatic vessels and what do they do?

A

They are open-ended vessels that collect the lymph, and carry it from the tissues into larger vessels

They have valves to prevent retrograde motion of length

227
Q

How many liters of fluid is drained daily by the lymphatic system?

A

2-4 liters

228
Q

What are lymph nodes?

A

Lymphatic vessels lead to lymph nodes.

They are a small organs that contain immune cells that look for antigens in the lymph before sending it through the efferent lymphatic vessel

229
Q

What kind of lymph nodes does the lymph from the upper limb passes through?

A

Axillary lymph nodes

230
Q

Name the type of lymph nodes found in the upper arm

A
  1. Humeral axillary nodes
  2. Central axillary nodes
  3. Apical axillary nodes
  4. Supraclavicular nodes
  5. Subscapular posterior axillary nodes
  6. Pectoral anterior axillary nodes
231
Q

What is lymphedema?

A

Block in the flow of length results in edema or swelling.

Anatomy (6 decks)

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