Upper Extremity Flashcards by Jasper Viloria

Shape of the axilla

Pyramidal

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Anterior / Pectoral boundary of the axillay is composed of (3):

Pectoralis major
Pectoralis minor
Subclavius

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The subscapularis, latissimus dorsi, and teres major are boundaries of the axilla on this side

Posterior / Scapular

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Ribs that form the medial boundary of the axilla

2nd to 6th rib

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Muscles on the medial / costal boundary of the axilla

Intercostal muscles

Serratus anterior

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Lateral boundary of the axilla (4):

Humerus
Long head of the biceps brachii
Short head of the biceps brachii
Coracobrachialis

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Three bones that comprise the apex of the axilla

Clavicle (anterior)
Scapula (posterior)
First rib (medial)

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The axillary vein, axillary artery, and the brachial plexus are enclosed by

Axillary fascia

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The axillay fascia is the lateral extension of this structure

Prevertebral fascia

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The rotator cuff is weakest on this side

Inferior

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Four tendons that form the rotator cuff

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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Forms the posterior part of the rotator cuff (2)

Infraspinatus

Teres minor

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Main abductor of the shoulder

Deltoid

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The axillary nerve innervates these two intrinsic muscles of the shoulder

Teres minor

Deltoid

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Lateral rotators of the shoulder

Infraspinatus

Teres minor

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The suprascapular nerve innervates these two rotator cuff muscles

Supraspinatus

Infraspinatus

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This muscle initiates abduction of the shoulder

Supraspinatus

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Innervation of subscapularis

Upper subscapular nerve

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Innervation of teres major

Lower subscapular

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Most common dislocation of the shoulder

Anterior inferior

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Rotator cuff tendon that is most frequently torn / inflamed

Supraspinatus

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Boundaries of the quadrangular space

Superior: Teres minor
Inferior: Teres major
Medial: Long head of triceps brachii
Lateral: Surgical neck of the humerus

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The quadrangular space contains (2)

Axillary nerve

Posterior circumflex humeral vessels

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The posterior circumflex humeral artery is a branch of:

Third part of the axillary artery

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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?

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

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

Dermatome at the tip of shoulder

Dermatome at the thumb

Dermatome at the middle finger

Dermatome at the little finger

T4 dermatome is at the level of the

Nipples

Landmark used to locate T10 dermatome

Umbilicus

Dermatome at the inguinal area

L4 dermatome covers the:

Knee and medial leg

Dermatome at lateral leg and big toe

Dermatome at the perineum

Dermatome at the small toe

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