Upper Extremities Flashcards
Abductor of the shoulder joint
Deltoid (main) -axillary n.
Supraspinatous (initiates) -suprascalular n.
Lateral rotators of the shoulder joint
Infraspinatus -suprascapular n.
Teres minor -axillary n.
Weakest part of the rotator cuff
Inferior
Injury to the axillary nerve causes…
Problems on lateral rotation and abduction
What muscle when inflammed causes pain on abduction?
Supraspinatus muscle
Action of teres major
Medial rotator
All anterior compartment muscles of the arm are ___
flexors
C5, C6 Lesion, affects PROXIMAL muscles and sensation of LATERAL arm, “waiter’s tip” hand
Erb-Duchenne’s Syndrome
C8, T1 lesion, affects DISTAL muscles and sensation of the MEDIAL hand, “claw hand”
Klumpke’s paralysis
What nerve and muscle is affected in “winged scapula”
Long thoracic n.
Serratus anterior m.
What nerve is affected in a condition where pt has diff elevating the trunk or using a crutch? Latissimus dorsi affected.
Thoracodorsal nerve lesion
What nerve is affected when there is difficulty abducting and rotating the arm laterally
Axillary nerve
Inflammation involving repetitive flexion and supination of the forearm
Medial epicondylitis
Golfer’s elbow
Inflammation resulting from repetitive flexion and extension of the forearm
Lateral epicondylitis
Tennis elbow
Rotator cuff muscles (SITS)
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
The APEX of the axilla is bound by what bones?
Ant: Clavicle
Post: Scapula
Medially: 1st rib
Contents of the axilla
Axillary artery and vein
Brachial plexus
Where will you palpate the pulse to guide in brachial n. plexus block?
3rd part of axillary artery
inject in the proximal pt of the sheath
Most common tendon inflamed in the rotator cuff?
Pain felt on ant and sup to the shoulder joint during abduction.
Supraspinatus tendon
Contents of the quadrangular space
axillary n.
posterior circumflex vessels
Contents of the triangular space
Circumflex scapular vessels
Anterior compartment muscles
Coracobrachialis
Brachialis
Biceps brachii
The anterior compartment is innervated by…
musculocutneous nerve
The posterior compartment muscle
Triceps brachii
Innervation of posterior compartment of the arm
Radial n.
Causes weakness in flexion of the forearm and weakness in supination; nerve compressed by the coracobrachialis
Musculocutaneous n. lesion
Caused by spiral fracture of the midshaft of the humerus; presents as “wrist drop” (weakness to extend hand, loss of ext at MP jts)
Radial n. lesion
PROXIMAL lesion on the MEDIAN N. due to SUPRACONDYLAR fracture of the humerus causes what sign?
Hand of benediction
(weakness in flexion at wrist, lat fingers and thumb;
alt sn on lat 3.5 digits and thenar eminence)
DISTAL lesion of the MEDIAN N. d/t lunate dislocation; weakness in opposition of thumb (adducted and extended);
“pins and needles”
Carpal tunnel syndrome
9 tendons that pass through carpal tunnel
4 of the FDP
4 of the FDS
Tendon of the FPL
What nerve is affected in the MEDIAL EPICONDYLE fracture of the humerus?
Ulnar n.
Distal lesion of the ULNAR N. d/t fracture of hook of HAMATE causes what sign? (Pt cannot hold paper in b/w fingers)
Claw hand
weakness of medial 2 lumbricals
Muscle that adducts arm and rotates it medially
Pectoralis major
Muscle that depresses pt of shoulder
Pectoralis minor
Muscle that depresses clavicle
Subclavius
Muscle that draws the scapula forward
Serratus anterior
What structure divides the axillary a. in 3 pts?
Tendon of pectoralis minor
3 pts of the axillary a.
Superior thoracic
Thoraciacrimial
Subcapsular a.
Radial artery begins in the cubital fossa at the level of the ___
neck of radius
Site for taking the radial pulse: tendon of brachioradialis on its ___ side and the tendon if FCR on its ____ side.
lateral
medial
Thenar muscles
AFO PoBre
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Nerve supply of thenar muscles
Median n.
Hypothenar muscles
AFO digiti minimi
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
Action of flexor digitorum profundus (FDP)
Flexes DIP
supplied by median and ulnar n
Action of flexor digitorum superficialis
flexes the PIP jts
supplied by the median n
Action of palmar interossei
PAD DAB
ADduct fingers
Action of dorsal interossei
PAD DAB
ABduct fingers
What brachial plexus cord does the MUSCULOCUTANEOUS N. belong?
Lateral cord
What brachial plexus cord does the ULNAR N. belong?
Medial cord
What brachial plexus cord does the AXILLARY and RADIAL N. belong?
Posterior cord
What does the median n. innervate?
Anterior/ flexor compt of forearm except:
flexor carpi ulnaris (FCU)
flexor digitorum profundus (FDP)
Fracture of the surgical neck of the humerus injures what nerve?
Axillary n
Distal radial fracture with fragment dorsally placed
Colle’s fracture
Distal radial fracture with fragment ventrally placed
Smith’s fracture
Metacarpals proximal row (lat-med)
Scaphoid
Lunate
Triquetral
Pisiform
Metacarpals distal row (lat-med)
Trapezium
Trapezoid
Capitate
Hamate
Boundaries of anatomical snuffbox
Lat: tendons of AbPoLo and ExPoBre
Med: tendon of ExPoLo
Floor: Scaphoid
Pain and tenderness on the anatomical snuff box
Scaphoid fracture
Most commonly dislocated carpal bone
Lunate
Localized thickening and contracture of the palmar aponeurosis; causes flexion of PIP
Dupuytren’s contracture
Fracture of the 1st metacarpal bone; thumb forcefully abducted
Bennett’s fracture
Oblique fracture of the necks of the 4th and 5th metacarpals; distal segment proximal (shorten finger)
Boxer’s fracture
Dermatome on back of the head
C2
Dermatome on the tip of the shoulder
C5
Dermatome of the thumb
C6
Dermatome of the middle finger
C7
Dermatome of the small finger
C8
Dermatome of the nipple
T4
Dermatome of the umbilicus
T10
Dermatome of the inguinal region
L1
Dermatome of the knee and medial leg
L4
Dermatome of the lateral leg and big toe
L5
Dermatome of the small toe
S1
Dermatome of the perineum
S5
All left LN drain into the ___
Thoracic duct
All right LN drain into the ____
Right lymphatic duct
Spinal root mediating biceps brachii reflex
C5
Spinal root mediating brachioradialis reflex
C6
Spinal root mediating triceps brachii reflex
C7