Upper Extremity Flashcards
Shape of the axilla
Pyramidal
Anterior / Pectoral boundary of the axillay is composed of (3):
Pectoralis major
Pectoralis minor
Subclavius
The subscapularis, latissimus dorsi, and teres major are boundaries of the axilla on this side
Posterior / Scapular
Ribs that form the medial boundary of the axilla
2nd to 6th rib
Muscles on the medial / costal boundary of the axilla
Intercostal muscles
Serratus anterior
Lateral boundary of the axilla (4):
Humerus
Long head of the biceps brachii
Short head of the biceps brachii
Coracobrachialis
Three bones that comprise the apex of the axilla
Clavicle (anterior)
Scapula (posterior)
First rib (medial)
The axillary vein, axillary artery, and the brachial plexus are enclosed by
Axillary fascia
The axillay fascia is the lateral extension of this structure
Prevertebral fascia
The rotator cuff is weakest on this side
Inferior
Four tendons that form the rotator cuff
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Forms the posterior part of the rotator cuff (2)
Infraspinatus
Teres minor
Main abductor of the shoulder
Deltoid
The axillary nerve innervates these two intrinsic muscles of the shoulder
Teres minor
Deltoid
Lateral rotators of the shoulder
Infraspinatus
Teres minor
The suprascapular nerve innervates these two rotator cuff muscles
Supraspinatus
Infraspinatus
This muscle initiates abduction of the shoulder
Supraspinatus
Innervation of subscapularis
Upper subscapular nerve
Innervation of teres major
Lower subscapular
Most common dislocation of the shoulder
Anterior inferior
Rotator cuff tendon that is most frequently torn / inflamed
Supraspinatus
Boundaries of the quadrangular space
Superior: Teres minor
Inferior: Teres major
Medial: Long head of triceps brachii
Lateral: Surgical neck of the humerus
The quadrangular space contains (2)
Axillary nerve
Posterior circumflex humeral vessels
The posterior circumflex humeral artery is a branch of:
Third part of the axillary artery
Boundaries of the triangular space
Superior: Teres minor
Inferior: Teres major
Lateral: Long head of the triceps brachii
The triangular space contains the:
Circumflex scapular vessels
The anterior compartment of the arm are is innervated by the:
Musculocutaneous nerve
Action of corachobrachialis
Adducts and flexes arm
Main flexor of the forearm
Brachialis
Main supinator of the forearm
Biceps brachii
Innervation of triceps brachii
Radial nerve
Inability to supinate the forearm could result from injury to these nerves (2)
Musculocutaenous and radial nerves
Superficial flexor of the forearm that is innervated by the ulnar nerve
Flexor carpi ulnaris
The common flexor tendon of the forearm originates at:
Medial epicondyle of the humerus
The extensors of the forearm are all innervated by:
Radial nerve
Lateral epicondylitis is also known as
Tennis elbow
Repetitive flexion and pronation of the elbow can result in
Medial epicondylitis / Golfer’s elbow
Four contents of the cubital fossa, from medial to lateral
Median nerve
Brachial artery
Biceps brachii tendon
Radial nerve
These two muscles form the floor of the cubital fossa
Brachialis
Supinator
Pronator teres is a boundary of the cubital fossa on this aspect
Medial
Three thenar muscles
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Intrinsic hand muscles that abduct the fingers
Dorsal interossei
How many palmar interossei are there in one hand?
3
Innervation of lumbricales
Ulnar and median nerve
Innervation of interossei
Ulnar nerve
These intrinsic hand muscles flex the metacarpophalangeal joints
Lumbricales
Innervates the medial side of the flexor digitorum profundus
Ulnar nerve
Muscles that flex the proximal interphalangeal joints
Flexor digitorum superificialis
The anterior division of the inferior trunk of the brachial plexus extends as this cord
Medial cord
Terminal branch of the brachial plexus that is formed by the lateral and medial cord
Median nerve
The dorsal scapular nerve innervates this muscle
Rhomboids
Tendon reflexes in the upper extremity and the main spinal roots being tested (3 pairs)
C5: Biceps brachii
C6: Brachioradialis
C7: Triceps
Waiter’s tip position of the arms is a physical finding of this syndrome.
Erb-Duchenne’s syndrome
Klumpke’s paralysis results from the compression of the ventral rami of these spinal roots
C8 and T1
Lesions of the ventral rami of C5 and C6, such as in Erb-Duchenne’s syndrome, affect the sensation on this aspect of the upper extremity
Lateral arm and forearm
Thumb and index finger
Weakness of the intrinsic muscles of the hand, as in Klumpke’s palsy, produce these physical findings
Ape hand
Claw hand
Winged scapula is a physical finding when this nerve is injured
Long thoracic nerve
Patients with long thoracic nerve lesions have difficulty in (2)
Protracting the scapula
Raising the arm above the head
Innervation of the latissimus dorsi
Thoracodorsal nerve
A fracture of the surgical neck of the humerus commonly affects this nerve
Axillary nerve
Spiral fractures of the humeral midshaft results in the inability to
Extend the wrist (“wrist-drop”)
Supracondylar fractures of the humerus can transect this nerve
Median nerve
“Papal benediction” is a finding in a proximal lesion of
Median nerve
Anterior boundary of the carpal tunnel
Flexor retinaculum / Transverse carpal ligament
Aside from the median nerve and the eight tendons of the flexor digitorum muscles, the carpal tunnel contains the tendon of:
Flexor pollicis longus
One would suspect a lesion in this nerve in a patient who has difficulty in flexing the wrist
Ulnar nerve
Distal lesions of the median and ulnar nerves can present as these characteristic findings that are also found in Klumpke’s palsy
Ape hand and claw hand, respectively
This muscle divides the axillary artery into three parts
Pectoralis minor
This artery supplies the first two intercostal spaces
Superior thoracic artery
The brachial artery branches into the radial and ulnar arteries at the level of the:
Radial neck
This vein ascends the lateral side of the biceps brachii
Cephalic vein
This vein connects the cephalic and brachial veins
Median cubital vein
The first bone of begin ossification during fetal development and the last one to complete ossification at around 21 years of age
Clavicle
Flattened part of the clavicle
Lateral 1/3
This muscle pulls the medial part of the clavicle upward
Sternocleidomastoid
The ulnar nerve is commonly injured when this part of the humerus sustains a fracture
Medial epicondyle
The deltoid and pectoralis major pulls the lateral side of the clavicle in this direction
Inferior
Fall on an outstretched hand produces this type of distal radial fracture
Colles fracture / Silver fork deformity
In Smith’s fracture, the hand is displaced in this direction
Anteriorly
What artery can be palpated on the anatomical snuff box?
Radial artery
Wrist bone that forms the floor of the snuff box
Scaphoid
Tendons that form the boundaries of the anatomical snuff box
Lateral: Tendons of extensor pollicis brevis and abductor pollicis longus
Medial: Tendon of extensor pollicis longus
Most commonly fractured bone in the wrist
Scaphoid
Total number of carpal bones in the body
16
Most commonly dislocated carpal bone
Lunate
In this physical finding, the ring and little fingers are flexed at the proximal interphalangeal joints due to localized thickening of the palmar aponeurosis
Dupuytren’s contracture
A fracture of the base of the first metacarpal bone that results from forceful abduction of the thumb
Bennet’s fracture
Oblique fracture of the necks of the fourth or fifth metacarpals, displacing the distal segments posteriorly
Boxer’s fracture
Dermatome at the back of the head
C2
Dermatome at the tip of shoulder
C5
Dermatome at the thumb
C6
Dermatome at the middle finger
C7
Dermatome at the little finger
C8
T4 dermatome is at the level of the
Nipples
Landmark used to locate T10 dermatome
Umbilicus
Dermatome at the inguinal area
L1
L4 dermatome covers the:
Knee and medial leg
Dermatome at lateral leg and big toe
L5
Dermatome at the perineum
S5
Dermatome at the small toe
S1
Three components of the group I nodes of the axilla
Anterior / Pectoral lymph nodes
Posterior / Scapular lymph nodes
Lateral / Humeral lymph nodes
Apical lymph nodes on the left drain into the
Thoracic duct
Also known as group II lymph nodes of the axilla
Central lymph nodes
The axillary nerve is a branch of which brachial plexus cord
Posterior cord
Two terminal branches of the posterior cord of the brachial plexus
Axillary nerve
Radial nerve
The suprascapular nerve is a branch of this brachial plexus trunk
Superior trunk