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BOARDS: Basic Anatomy > Upper Extremity > Flashcards

Upper Extremity Flashcards

1
Q

What bone connects the upper limb to the axial skeleton?

A

clavicle

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2
Q

What additional motion of the clavicle on the sternum do we get with arm elevation, besides simply elevation of the clavicle?

A

posterior rotation

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3
Q

What does the costoclavicular ligament do?

A

connects clavicle to first rib, so prevents excessive elevation/protraction

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4
Q

T/F: The SC joint isn’t very stable.

A

false; because of all the ligaments (interclavicular, costoclavicular, etc) it’s VERY stable… more likely to break clavicle

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5
Q

What ligaments make up the AC joint?

A

1) coracoclavicular (two parts, trapezoid and conoid) -> this REALLY holds AC together
2) acromioclavicular (prevents post. translation)

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6
Q

What part of the clavicle is most likely to fracture?

A

between medial 2/3s and lateral 2/3, just medial to the attachment of coracoclavicular ligament

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7
Q

What spinal level is the spine of the scapula at?

A

T3 (superior border at T2)

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8
Q

What vertebral level is the inferior angle of the scapula at?

A

T7

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9
Q

What are the four joints of the upper extremity?

A

1) sternoclavicular
2) acromioclavicular
3) glenohumeral
4) scapulothoracic

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10
Q

What ligaments support the glenohumeral joint?

A

superior/inferior/middle glenohumeral ligaments resist excessive anterior translation

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11
Q

What are the 4 rotator cuff muscles?

A

supra
infra
subscap
teres minor

ALL insert into joint capsule

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12
Q

How much elevation occurs at the GH joint compared to the scapulothoracic joint?

A

120deg elevation at GH

60 deg elevation at scapulothoracic

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13
Q

Full scapular upward rotation requires what motion at the clavicle?

A

backward rotation (45-50deg)

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14
Q

What is the ratio for scapular to humeral motion with elevation?

A

1:2 (scapular:humeral)

aka scapulohumeral rhythm

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15
Q

What muscles cause upward rotation of the scapula during elevation?

A

upper trapezius and serratus anterior

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16
Q

What muscles cause downward rotation of the scapula during shoulder extension? (like chopping wood)

A

levator scapulae, rhomboids, pec minor

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17
Q

What muscles are active with shoulder protraction?

A

serratus anterior, pec minor

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18
Q

What muscles depress the scapula?

A

lower trap, pec minor, lat

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19
Q

What nerve is compressed in “crutch palsy”?

A

radial (formerly axillary a.)

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20
Q

Describe arterial flow in the upper extremity.

A

subclavian a. -> axillary a. -> brachial a. -> dive apart into radial and ulnar a.

THEN they kinda joint up in palmar arches in hand

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21
Q

What bony landmarks make up the humeroulnar joint?

A

trochlear notch of ulna, trochlea of humerus

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22
Q

What bony landmarks make up the radiohumeral joint?

A

capitulum of humerus and radial head

23
Q

What is the capsular pattern of the humeral-ulnar joint?

A

flexion, extension

24
Q

What is the capsular pattern of the humeral-radial joint?

A

flexion, extension, supination, pronation

25
Q

In what position should you manipulate the humeral-ulnar joint?

A

70deg flex

10 deg sup

26
Q

In what position should you manipulate the radio-humeral joint?

A

max extension, and supination

coincidentally the CLOSED pack position for humeroulnar

27
Q

What kind of joint is the superior radioulnar joint?

A

pivot joint: radial head against medial proximal ulna in radial notch

28
Q

What connects the middle of the radius and ulna?

A

interosseous membrane (stabilizes for pushing) and oblique cord (stabilizes for pulling)

29
Q

What elbow flexor gets dual innervation?

A

brachialis:
1) musculocutaneous
2) radial nerve branch to brachialis

30
Q

What is the main muscle of elbow flexion, working in all positions of the forearm?

A

brachialis

31
Q

What muscles facilitate elbow extension in a closed-chain position?

A

pec major and anterior delt (like with push ups)

32
Q

Elbow has to be in what position for biceps brachii to do supination?

A

90 deg elbow flexion

33
Q

Describe pushing/pulling force coupling.

A

1) pushing = getting elbow extension with shoulder flexion, so need triceps extending elbow, biceps flexing shoulder and controlling ext.
2) pulling = doing opposite

34
Q

T/F: Triceps are active when performing screwdriving motion.

A

yes, to resist elbow flexion as biceps works as a supinator

35
Q

What is a Volkmann’s ischemic contracture?

A

occlusion/laceration of brachial a. in upper arm can result in ischemia in forearm, causing ischemic contracture permanently shortening the involved muscles

36
Q

What is a Colles fracture, and what commonly causes it?

A

it’s a fracture at the distal radius, d/t fall on outstretched hand

37
Q

In what area is the ulnar nerve most often compressed?

A

Osborne’s fascia, forming the cubital tunnel posterior to the medial epicondyle

38
Q

Name the proximal row of carpal bones, lateral to medial.

A

schaphoid
lunate
triquetrum
pisiform

39
Q

Name the distal row of carpal bones, lateral to medial.

A

Trapezium (thumb)
Trapezoid
Capitate
Hamate

40
Q

What is the most frequently fractured carpal bone, and its common complication?

A

scaphoid

- avascular necrosis often occurs d/t poor blood supply that impacts healing

41
Q

Name the three arches of the hand; what action do they support?

A

longitudinal
metacarpophalangeal transverse
carpal transverse

Assist with prehension (grasp)

42
Q

In the distal radioulnar joint, what bone moves on what with supination/pronation?

A

radius moves on ulna

43
Q

What bears more load, radius or ulna?

A

radius (60:40)

44
Q

What is the most commonly dislocated carpal bone?

A

lunate (anteriorly) - can compress median nerve

45
Q

What is the most active muscle with grasping?

A

ECRB, which holds wrist in extension

46
Q

Describe the innervation of the hand.

A

all ulnar except 1/2 LOAF median:

1) lateral half of lumbricals
2) opponens pollicis
3) abductor pollicis
4) flexor pollicis brevis

47
Q

Name the deep muscles of the anterior forearm.

A

1) flexor digitorum profundus
2) flexor pollicis longus
3) pronator quadratus

48
Q

Innervation of the forearm?

A

all median except FCU and medial half of FDP

49
Q

What are the two major wrist flexors?

A

FCU and FCR (FCR more effective)

- palmaris longus also does slight wrist flexion

50
Q

A supercondylar fracture in the humerus can damage what artery?

A

radial a.

51
Q

If a power grip is damaged in an individual, what nerve is thought to be damaged?

A

ulnar n.

52
Q

If a precision grip is damaged, what nerve is thought to be the cause?

A

median n.

53
Q

If a patient has trouble releasing an object, what nerve may be damaged?

A

radial n.

BOARDS: Basic Anatomy (4 decks)

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