Upper Extremity Flashcards by Jamaira Belmes

Stabilizes the shoulder joint - anterior, superior and posterior parts

WEAKEST on INFERIOR

ROTATOR CUFF MUSCLES

SITS

Supraspinatus - above
Infraspinatus - below
Teres minor - posterior
Subscapularis - anterior

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Intrinsic Muscles of the Shoulder

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Deltoid
Teres major

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Lateral Rotator (Intrinsic Muscles of the Shoulder)

Infraspinatus – suprascapular nerve

Teres minor – axillary nerve

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Abductor (Intrinsic Muscles of the Shoulder)

Supraspinatus – suprascapular nerve

Deltoid – axillary nerve

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Medial Rotator (Intrinsic Muscles of the Shoulder)

Subscapularis – upper subscapular nerve

Teres major – lower subscapular nerve

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Muscles of the Arm

ANTERIOR COMPARTMENT (FLEXOR)

POSTERIOR COMPARTMENT (EXTENSOR)

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Muscles of the Arm

ANTERIOR COMPARTMENT (FLEXOR)

musculocutaneous nerve

Coracobrachialis - adducts/flexes the arm

Brachialis - MAIN FLEXOR of the forearm

Biceps Brachii - flexor and MAIN SUPINATOR of the forearm

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Muscles of the Arm

POSTERIOR COMPARTMENT (EXTENSOR)

radial nerve

Triceps brachii - MAIN EXTENSOR of the forearm

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Muscles of the Forearm

ANTERIOR (FLEXORS)

LATERAL

POSTERIOR (EXTENSORS)

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Muscles of the Forearm

ANTERIOR (FLEXORS)

median nerve EXCEPT FCU and FDP

SUPERFICIAL
Pronator teres - pronation and flexion of the forearm
Flexor Carpi Radialis
Palmaris longus
Flexor Carpi Ulnaris

INTERMEDIATE
Flexor Digitorum Superficialis

DEEP
Flexor Pollicis Longus
Flexor Digitorum Profundus
Pronator Quadratus - pronates forearm

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Common FLEXOR tendon

Medial Epicondyle of Humerus

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Muscles of the Forearm

LATERAL

radial nerve

Brachioradialis - FLEXOR of the forearm

Extensor Carpi Radialis Longus - extends and abducts hand at wrist joint

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Muscles of the Forearm

POSTERIOR (EXTENSORS)

radial nerve

SUPERFICIAL
Extensor Carpi Radialis Brevis
Extensor Digitorum
Extensor Digiti Minimi
Extensor Carpi Ulnaris
Anconeus - EXTENDS elbow joint

DEEP 
Abductor Pollicis Longus
Extensor Pollicis Brevis
Extensor Pollicis Longus
Extensor Indicis
Supinator - SUPINATION of the forearm

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Common EXTENSOR tendon

Lateral Epicondyle of Humerus

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Inflammation of the common flexor tenson - medial epicondyle tendon

repetitive FLEXION and PRONATION of the forearm at the elbow

GOLFER’s ELBOW

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Inflammation of the common extensor tenson - lateral epicondyle tendon

results from forced EXTENSION and FLEXION of the forearm at the elbow

TENNIS ELBOW

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Thenar Muscles

MEDIAN NERVE

AFO

Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis

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Hypothenar Muscles

ULNAR NERVE

AFO

Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi

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Intrinsic Muscles of Hand

ULNAR NERVE EXCEPT lateral/ 1st and 2nd lumbricals - MEDIAN nerve

Palmar interossei (4) - ADDuct fingers

Dorsal interossei (4) - ABDuct fingers

Lumbricals (4) - flexes MCP joints

lateral/first and 2nd - median nerve
3rd and 4th - ulnar nerve

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Extrinsic Muscles of the Hands

Flexor digitorum superficialis - flexes the PROXIMAL IP joints - MEDIAN nerve

Flexor digitorum profundus - DISTAL IP joints - MEDIAN and ULNAR nerve

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Axilla - pyramidal in shape

BOUNDARIES
anterior (pectoral)
posterior (scapular)
*medial (costal)
*lateral (humeral)

APEX
clavicle (anterior)
scapula (posterior)
1st rib (medial)

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Contents of the Axilla

Axillary vein
Axillary artery
Brachial plexus

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Quadrangular Space

BOUNDARIES

above - TERES MINOR
below - TERES MAJOR
medial - LONG HEAD OF TRICEPS BRACHII
lateral - SURGICAL NECK OF HUMERUS

CONTENTS
axillary nerve (circumflex) nerve
posterior circumflex humeral vessels

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Triangular Space

BOUNDARIES

above - TERES MINOR
below - TERES MAJOR
lateral - LONG HEAD OF TRICEPS BRACHII

CONTENTS
circumflex scapular vessels

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Triangular Interval

BOUNDARIES above - TERES MINOR medial- LONG HEAD OF TRICEPS BRACHII lateral - LATERAL HEAD OF TRICEPS OR HUMERUS CONTENTS radial nerve profunda brachii artery

Cubital Fossa

BOUNDARIES lateral - BRACHIORADIALIS medial - PRONATOR TERES upper - HORIZONTAL LINE CONNECTING THE EPICONDYLES OF HUMERUS floor - BRACHIALIS and SUPINATOR ``` CONTENTS median nerve brachial artery biceps brachii tendon radial nerve ```

Anatomical Snuff Box

Lateral - tendons of EPB and APL Med - tendon of EPB Floor - Scaphoid Trapezium

Continuation of SUBCLAVIAN a From 1st rib to teres major Tendon of PECTORALIS MINOR divides the vessel into 3 parts

AXILLARY ARTERY 1st PART *superior thoracic artery (highest thoracic artery) ``` 2nd PART Thoracoacromial *pectoral *acromial *deltoid *clavicular ``` Lateral Thoracic 3rd PART Subscapular - LARGEST branch *Thoracodorsal *Circumflex scapular Anterior Circumflex Humeral Posterior Circumflex Humeral

Axillary artery continues as

Brachial artery Radial/Ulnar artery Palmar arch

Superficial lymphatic vessels from the THUMB, INDEX and LATERAL side of the HAND follow the

CEPHALIC vein -- INFRACLAVICULAR LYMPH NODES

Superficial lymphatic vessels from the MEDIAL side of the HAND follow the

BASILIC vein -- SUPRATROCHLEAR LYMPH NODES -- LATERAL GROUP of axillary lymph nodes

Deep lymphatic vessels follow the arteries to the

LATERAL GROUP of axillary lymph nodes

Displacement of the bones at the GLENOHUMERAL JOINT

SHOULDER DISLOCATION anterior inferior dislocation posterior dislocation

Clavicle torn away from the end of acromion Occurs at the ACROMIOCLAVICULAR joint

SHOULDER SEPARATION

Most commonly affected tendon in inflammation of rotator cuff

SUPRASPINATUS pain anterior and superior to the shoulder during ABDUCTION

Compression of the suprascapular nerve as it passes through the suprascapular notch severe deep aching pain that radiates from the top of the scapula to the ipsilateral shoulder

Suprascapular Nerve Entrapment

Brachial Plexus

5 roots - C5, C6, C7, C8, T1 3 trunks * C5,C6 - superior * C7 - middle * C8,T1 - inferior 6 divisions 3 anterior 3 posterior 3 cords lateral posterior medial

Branches of Brachial Plexus

lateral cord -- MUSCULOCUTANEOUS (C5-C7) posterior cord - AXILLARY (C5-C6) posterior cord - RADIAL (C5-T1) lateral and medial - MEDIAN (C5-T1) medial - ULNAR (C7-T1)

Brachial Plexus - AXILLARY (C5-C6) Nerve

Deltoid, Teres Minor

Brachial Plexus - MUSCULOCUTANEOUS (C5-C7) Nerve

FLEXOR compartment of the arm

Brachial Plexus - RADIAL (C5-T1) Nerve

EXTENSOR compartment of arm and forearm

Brachial Plexus - MEDIAN (C5-T1) Nerve

FLEXOR compartment of forearm EXCEPT FCU and MEDIAL SIDE OF FDP THENAR muscles

Brachial Plexus - ULNAR (C7-T1) Nerve

Intrinsic muscles of the hand HYPOTHENAR muscle

Long Thoracic Nerve (C5-C7)

Serratus anterior

Suprascapular (C5-C6)

Infraspinatus | Supraspinatus

Occurs d.t. fall on the shoulder of during a difficult delivery UPPER BRACHIAL PLEXUS INJURY (C5 and C6) arm medially rotated and forearm pronated lateral - sensory loss

ERB DUCHENNE (Waiter's tip)

Occurs d.t. excessive abduction of the arm or by stab or bullet wounds LOWER BRACHIAL PLEXUS INJURY (C8 and T1) weakness of the wrist and finger flexors of the hand medial - sensory loss

KLUMPKE (Claw hand)

Most commonly injured as it courses superficial to the SERRATUS ANTERIOR on the lateral wall of the thorax "WINGED SCAPULA" thoracic surgery, radical mastectomy, stab wound

LONG THORACIC NERVE LESIONS weakness in ability to PROTRACT the scapula and difficulty in raising their arm above the head

May be a result of SURGICAL PROCEDURE OF THE AXILLA LATISSIMUS DORSI - affected

THORACODORSAL NERVE LESIONS

May be injured as a result of DISLOCATION of the HEAD of the HUMERUS or by a FRACTURE of the SURGICAL NECK of the HUMERUS

Axillary Nerve Lesions downward shoulder dislocations paralysis of the deltoid and teres minor muscle -- loss of abduction from 15-90

Occurs d.t. SPIRAL FRACTURE of the MIDSHAFT of the humerus or crutches pressing in axilla Saturday night palsy WRIST DROP

RADIAL NERVE LESION

PROXIMAL lesion - SUPRACONDYLAR FRACTURE of the HUMERUS Compression b/w heads of pronator teres muscle Altered cutaneous sensation - lateral 3 and 1/2 digits and thenar eminence Weakness in flexion at wrist; flexion of lateral fingers and flexion of thumb

MEDIAN NERVE LESIONS HAND OF BENEDICTION

DISTAL lesion - CARPAL TUNNEL SYNDROME; LUNATE dislocation Numbness and pain over the palmar aspects of thumb, index and middle finger Altered cutaneous sensation - lateral 2 and 1/2 digits Weakness in OPPOSITION of thumb; remains ADDUCTED and EXTENDED

MEDIAN NERVE LESIONS APE HAND

Entrapment of the MEDIAN nerve within the CARPAL TUNNEL pain, sensory paresthesia and muscle weakness

Carpal Tunnel Syndrome burning pain or "pins and needles"

Lies b/w the TENDONS of FLEXOR DIGITORUM SUPERFICIALIS and FLEXOR CARPI RADIALIS

Median Nerve

PROXIMAL lesion - MEDIAL EPICONDYLE fracture of the humerus altered cutaneous sensation - medial 1 and 1/2 digits and hypothenar eminence weakness in flexion of medial fingers; flexion at wrist

ULNAR NERVE LESIONS

DISTAL lesion - FRACTURE hook of HAMATE altered sensation in skin of the medial aspect of the hand and digits

ULNAR NERVE LESIONS CLAW HANDS

HUMERAL FRACTURES

Surgical neck - AXILLARY NERVE; posterior circumflex artery may be lacerated midshaft/spiral - RADIAL NERVE and profunda brachial artery may be affected supracondylar - MEDIAN NERVE; contraction of triceps and brachialis may shorten the arm medial epicondyle - ULNAR NERVE

Fall on the shoulder or outstretched hand MOST COMMONLY FRACTURED BONE medial segment - elevated by pull of SCM lateral segment - displaced downward by gravity and pull of deltoid and pectoralis major BRACHIAL PLEXUS INJURY/LOWER TRUNK HEMORRHAGE from SUBCLAVIAN VEIN/ARTERY

CLAVICLE

Fracture of the BASE of the FIRST MCP bone

BENNETT FRACTURE

Oblique fracture of the NECKS of the 4th and 5th MCP

BOXER FRACTURE

Fall on the OUTSTRETCHED hand Distal segment POSTERIORLY and SUPERIORLY

COLLE/DINNER/SILVER FORK DEFORMITY Distal radial fracture, fragment dorsally placed

Fall on the BACK of the HAND ANTERIORLY

SMITH FRACTURE Distal radial fracture, fragment ventrally placed

MOST COMMONLY FRACTURED CARPAL BONE

SCAPHOID pain and tenderness localized over the anatomical snuffbox after a fall on the outstretched han

MOST COMMONLY DISLOCATED CARPAL BONE may cause CARPAL TUNNEL SYNDROME

LUNATE