Upper Extremity Flashcards
What are the bone boundaries of the apex of the axill?
- A: Clavicle
- P: scapula
- M: first rib
What is the anterior border of the axilla?
- Pectoralis major
2. Pectoralis minor
What is the medial border of the axilla?
- Serratus anterius
2. Thoracic wall
What is the posterior border of the axilla?
- Axillary vein
- Axillary artery
- Brachial plexus
The axillary fascia is a prolongation of what fascia?
prevertebral fascia
What are the components of you rotator cuff muscle?
Supraspinatus
Infraspinatus
teres minor
Subscaplularis
What intrinsic muscle medially rotates the shoulder?
- subscapularis
2. Teres major
What intrinsic laterally rotates the shoulder?
I. Infraspinatus
2. Teres minor
What intrinsic ABducts the shoulder?
- supraspinatus
2. Deltoid
When the shoulder joint is fully abducted then a force tilts the humeral head downward, then inferior, the dislocation will be ___
anterior inferior
What is the most commonly involved muscle in rotator cuff tendinitis?
supraspinatus
What joint is associated with shoulder dislocation
Glenohumeral
Wha joint is damaged in shoulder separation
Acromioclavicular
What are the contents of the quadrangular space in your shoulder?
- Axillary nerve (circumflex)
2. Posterior circumflex humeral vessels
What are the boundaries of your quadrangular space
- S: Teres minor
- Medial: long head of triceps brachii
- I: Teres major
- L: Surgical neck of humerus
What nerve is commonly damaged in glenohumeral joint sdislocation?
Axillary nerve
What nerve can be damages in surgical neck fracture of the humerus?
Axillary nerve
What are the different compartments of the arm?
- Anterior
2. Posterior
What is the main action of the anterior compartment of the arm?
It is the main flexor
What is the innervation of the anterior compartment of the arm
Musculocutaneous nerve
What is the main flexor of the forearm?
brachialis
What is the main supinator of the arm?
biceps brachii
What are the components of your anterior forearm?
- Coracobrachialis
- Brachialis
- Biceps brachii
What are the contents of your posterior compartment of the arm?
- Triceps brachii
What is the main action of the posterior compartment of the arm?
extensor
What innervates the posterior compartment of the arm?
radial nerve
What are the components of your superficial forearm
- Pronator teres
- Palmaris longus
- FCR
- FCU
- FDS
- Intermediate group
What innervates the FCU?
Ulnar nerve
The flexors of the forearm are innervated by the median nerve except ___
- FCU
2. FDP
What are the components of the deep group of forearm flexors?
- FPL
- FDP
- Pronator quardatus
What muscles commonly originate in the medial epicondyle?
- Pronator teres (humeral head)
- FCR
- Palmaris longus
- FCU - humeral head
- FDS - humeroulnar head
What innervates your extensor muscles of the forearm?
Radial nerve
The common flexor tendon inserts in what epicondyle?
medial epicondyle
The common extensor tendon inserts in what epicondyle?
- lateral
What muscles originate in the lateral epicondyle?
- ECRB
- ED
- EDM
- ECU
- Aconeus
- Supinator
Golfer’s elbow is an inflammation of ___
medial epicondyle
What action precipitates medial epicondylitis?
repetitive flexion and pronation
What is affected in Tennis Elbow?
Lateral epicondyle
Tennis elbow is due to what repetitive motion?
Extension and flexion of the forearm at the elbow
What are the contents of the cubital fossa?
- Median nerve
- Brachial artery
- Biceps brachii
- Radial nerve
What are the borders of your cubital fossa?
- S: horizontal line connecting the epicondyles of the humerus
- L: brachioradialis
- I: Brachialis and supinator
- M: pronator teres
What are the components of your thenar muscles?
- APB
- FPB
- OP
AFO
What innervates the thenar muscles?
median nerve
What are your intrinsic muscles of the hand?
- Palmar interossei
- Dorsal interossei
PAD-DAB
The radial nerve innervates this muscle of the hand
- Extensor digitorum
What muscle flexes the hands at the MCP?
lumbricals
What innervates the medial lumbricales?
ulnar nerve
What innervates the lateral lumbricals
median nerve
What muscle flexes the PIP joint?
- Flexor digitorum superficialis
What innervates the flexor of the muscle at the PIP joint?
median nerve
What flexes the muscle at the DIP?
Flexor digitorum profundus
What innervates the FDP?
- Median
2,. Ulnar
What muscle connects the UE to the thorax?
- Pectoralis major
- Pectoralus minor
- Serratus anterior
- Subclavius
The axillary artery starts from the ___ to the ___
First rib to teres major
Tendon of pectoralis minor
The superior thoracic artery supplies what part of the body?
First 2 intercostal space
What artery supplies the pectoral, acromial, deltoid, and clavicular?
Thoracoabdominal
What is the largest branch of the axillary artery
subscapular artery
The subscapular artery supplies what muscles?
- Subscapularis
- Teres major
- Latissimus dorsi
What are the branches of your subscapular artery?
- Thoracodorsal
- Anterior Circumflex humeral
- Posterior circumflex humeral
- Circumflex scapular
What artery supplies the serratus anterior?
Thoracodorsal artery
The radial artery starts at what level?
neck of radius
Where will you take the radial pulse?
- between the tendons of brachioradialis AND FCR
Lateral to the radial pulse is what tendon?
brachioradialis
Medial to the radial pulse is what tendon?
FCR
what artery can be palpated in the root of the posterior triangle as it cross the first rib?
subclavian artery
What artery can be felt in the axilla as it lies in front of the teres major?
axillary artery
What artery lies on the brachialis, overlapped from the lateral side by the biceps brachii
brachial artery
the cephalic vein drains to what vein
axillary vein
What vein ascends on the lateral side of the biceps brachii?
cephalic vein
What vein on the arm is thee choice for central venous catheterization and is directly in line with axillary vein
basilic vein
___ connects the cephalic and basilic vein
median cubital vein
what vein is seen in the antecubital fossa, frequent site of BE
median cubital vein
What are the contents of your antecubital fosaa (lateral to medial)
{Lateral to Medial]
- Brachioradialis
- Radial nerve
- Biceps tendon
- brachial artery
- brachial vein
- median nerve
- protanor teres
What bone begins to ossify first during fetal development
clavicle
What bone ossifies last?
Clavicle (at age 21)
Whe weakest point of the clavicle is the ____
junction
What is the most commonly fractured bone?
clavicle
After a clavicular fracture, the medial segment of the fractured bone is elevated by what muscle?
SCM
After a clavicular fracture, the medial segment of the fractured bone is elevated by what muscle?
- Pull of deltoid
2. Pectoralis major
[Humeral fracture]
Surgical neck fracture
axillary nerve
[Humeral fracture]
midshaft/spiral facture
radial nerve
[Humeral fracture]
supracondylar fracture
median nerve
[Humeral fracture]
medial epicondyle
ulnar
[Fracture of the lower end of radius]
the distal segment displaced posteriorly and superiorly
Distal radial fracture fragment dorsally placed
Colle/Dinner/Silver fork deformity
[Fracture of the lower end of radius]
the distal radial fracture fragment is displaced ventrally
distal segment anteriorly
Smith Fracture
[Fracture of the lower end of radius]
usual fracture if “fall on the back of hand”
Smith
[Fracture of the lower end of radius]
usual fracture if “FOOSH”
Colle/Dinner/Silver fork deformity
[Carpals]
Proximal carpal bones
(Lateral to Medial) Scaphoid/Navicular Lunate Triquetral Pisiform
Some Lovers Try Positions
[Carpals]
Distal carpal bones
(lateral to medial)
Trapezium
Trapezoid
Capitate
Hamate
That They Cant Handle
What are the boundaries of your anatomical snuff box?
(Lateral to medial)
- L: Tendons of EPB and ABD PL
- F: scaphoid
- M: tendon of EPL
- Trapezium
What artery can be palpated in the anatomical snuff box?
radial artery
Tenderness and pain over the anatomical snuff box after FOOSH suggests a fracture in teh
Scaphoid
What is the most commonly DISLOCATED carpal bone
Lunate
What is the typical dislocation of the lunate?
(Anterior/posterior?
anterior
Carpal Tunnel Syndrome can also present if this carpal bone is dislocated
lunate
__ contracture
localized thickening and contracture of the palmar aponeurosis
Dupuytren Contracture
___ contracture
flexion of the proximal interphalangeal joint
Dupuytren contracture
___ fracture
fracture of the base of the first metacarpal bone
bennett fracture
___ fracture
oblique fracture of the necks of the fourth or fifth metacarpasl
Boxers fracture
[Cutaneous Innervation]
lateral aspect of the base of the thumb
Radial nerve
[Cutaneous Innervation]
anterior aspect of the tip of thumb pointer finger middle finger 1/2 of ring ringer
median
[Cutaneous Innervation]
anterior aspect of the ring finger and medial 1/2 of the ring finger
ulnar nerve
[Dermatomes]
Back of head
C2
[Dermatomes]
tip of shoulder
C5
[Dermatomes]
thumb
C6
[Dermatomes]
middle finger
C7
[Dermatomes]
small finger
C8
[Dermatomes]
nipple
T4-T5
[Dermatomes]
umbilicus
T10
[Dermatomes]
inguinal
L1
[Dermatomes]
knee and medial leg
L4
[Dermatomes]
lateral leg and Big toe
L5
[Dermatomes]
small toe
S1
[Dermatomes]
perineum
S5
What nerve supplies the tip of the thumb, index finger, middle finger
median nerve
what nerve supplies the medial half of the tip of the middle finger?
median nerve
[Tendon reflex]
C5 can be checked by
Biceps brachii
[Tendon reflex]
C7 can be checked by
Triceps tendon
[Tendon reflex]
C6 can be checked by
Brachioradialis
[Tendon reflex]
L4 can be checked by
Patellar tendon
[Tendon reflex]
S1 can be checked by
Achilles tendon
[Lymphatic Drainage]
Thumb, index, lateral side of the hand
infraclavicular LN
[Lymphatic Drainage]
medial side of the hand
Supratrochlear LN then to the lateral group of the axillary LN
[Lymphatic Drainage]
lateral group
axillary LN
Cephalic Vein to Infraclavicular LN
Basilic vein = supratrochlear LN
[Axillary LN]
Level I is composed of
- Posterior (Subscapular)
- Lateral
- Anterior (external)
[Axillary LN]
Level II is composed of
- Central node
[Axillary LN]
Level III
- Apical/Subclavicular
What differentiates the 1st part and the 2nd part of the wrist?
Lister’s tubercle
What tendon winds around the lister’s tuberle?
EPB
The houseman’s vein is seen on the
anatomical snuff box