Upper Extremity Flashcards
Glenoid labrum is continuous with
The long head of the biceps and triceps tendons
Muscles of the rotator cuff
Supraspinatus, infraspinatus, teres minor, subscapularis
Muscles of shoulder external/lateral rotation
infraspinatus, teres minor
Muscles of shoulder internal/medial rotation
subscapularis
Muscles of arm abduction
supraspinatus, deltoid
Muscles of arm adduction
teres major, coracobrachialis
Muscles of scapula elevation
Levator scapulae, rhomboid minor/major, trapezius
Muscles of scapula depression
Subclavius, pectoralis minor
Muscles of scapula protraction
Pectoralis minor, pectoralis major, serratus anterior
Muscles of scapula retraction
Rhomboid minor, rhomboid major, trapezius, latissimus dorsi
Muscles of scapula upward rotation
Trapezius, serratus anterior
Muscles of scapula downward rotation
Latissimus dorsi
Function of the posterior compartment of the arm
Extension
“3” muscles of the posterior compartment of the arm
3 heads of the triceps brachii
3 muscles of the anterior compartment of the arm
Coracobrachialis, biceps brachii, brachialis
Innervation of the posterior compartment of the arm
Radial nerve
Innervation of anterior compartment of the arm
Musculocutaneous nerve
Blood supply of posterior compartment of the arm
Deep brachial artery
Blood supply of anterior compartment of the arm
Brachial artery
Function of anterior compartment of arm
Flexion, supination
Origin and insertion of biceps brachii (general)
Scapula, radius
Origin and insertion of brachialis (general)
Humerus, ulna
Origin and insertion of coracobrachialis (general)
Scapula, humerus
Action of biceps brachii
Flexion, supination
Action of brachialis
Flexion
Action of coracobrachialis
Flexion, adduction
Muscles of pronation
Pronator teres, pronator quadratus
Superficial muscles of anterior forearm (lateral to medial)
Pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, flexor digitorum superficialis
Superficial muscles of anterior forearm arise from
Medial epicondyle
Deep muscles of the anterior forearm
Pronator quadratus, flexor pollicis longus, flexor digitorum profundis
Most muscles of anterior forearm innervated by
median nerve
muscles of anterior forearm not innervated by median nerve
flexor carpi ulnaris, ulnar side of flexor digitorum profundis
3 “wrist” muscles of posterior forearm
Extensor carpi ulnaris, extensor carpi radialis longus, extensor carpi radialis brevis
3 “fingers” muscles of posterior forearm
Extensor digiti minimi, extensor digitorum, extensor indicis
3 “thumb” muscles of posterior forearm
Extensor pollicis longus, extensor pollicis brevis, abductor pollicis longus
3 “other” muscles of posterior forearm
Anconeus, supinator, brachioradialis
All posterior forearm muscles innervated by
Radial nerve
Fibrous joints
synarthroses
Cartilaginous joints
amphiarthroses
Synovial joints
diarthroses
Extrinsic ligament
outside the articular capsule
Intrinsic ligament
fused with the articular capsule
subscapularis is innervated by
subscapular nerve
supraspinatus is innervated by
suprascapular nerve
infraspinatus is innervated by
suprascapular nerve
teres minor is innervated by
axillary nerve
deltoid is innervated by
axillary nerve
muscle most commonly involved in rotator cuff injury
supraspinatus
ligament leading to impingement of supraspinatus
coracoacromial
Grade 1 AC separation
slight tearing or stretching of AC joint
Grade 2 AC separation
Total tearing of AC joint, CA joint remains intact
Most common type of AC separation
Grade 1
Grade 3 AC separation
AC, CA, joint capsule completely torn with deformity
Movements at radiocarpal joint
Flexion, extension, radial/ulnar deviation of hand
Movements at radioulnar joints
Pronation, supination
Functions of muscles of the anterior compartment of the forearm
Flex wrist/digits, pronate hand, radial/ulnar deviation
Blood supply of anterior compartment of forearm
Branches of radial and ulnar arteries
Functions of muscles of posterior compartment of forearm
Extend wrist/digits, supinate hand, extend/abduct thumb
Blood supply of posterior compartment of forearm
Branches of radial and ulnar arteries
Movements at metacarpophalangeal joint
Flexion, extension, abduction, adduction of digits
Movements at interphalangeal joints
Flexion and extension of middle and distal phalanges
Superficial intrinsic muscles of the hand
thenar, hypothenar, lumbricals, adductor pollicis
Most intrinsic hand muscles are innervated by
ulnar nerve
These intrinsic hand muscles are innervated by the median nerve
thenar, lateral lumbricals
Deep intrinsic hand muscles
palmar interossei, dorsal interossei
Action of palmar interossei
adduction of fingers
Action of dorsal interossei
abduction of fingers
Blood supply to the hand
Palmar arches (branches of radial and ulnar arteries)
6 branches of axillary artery
Superior thoracic, Thoracoacromial, lateral thoracic, subscapular anterior humeral circumflex, posterior humeral circumflex
Branch of sublclavian artery important for collateral circulation of shoulder
Thyrocervical trunk
3 branches of the thyrocervical trunk
Suprascapular, transverse cervical, dorsal scapular
Branch of subscapular artery important for collateral circulation of shoulder
Circumflex scapular artery
Terminal branches arising from roots (and which roots they arise from)
Dorsal scapular (C5), Long thoracic (C5-C7)
Terminal branches arising from trunks (and which trunks they arise from)
Suprascapular (upper trunk)
Terminal branches arising from lateral cord
Lateral pectoral, median, musculocutaneous
Terminal branches arising from medial cord
Medial pectoral, medial cutaneous arm, medial cutaneous forearm, median, ulnar
Terminal branches arising from posterior cord
Upper subscapular, lower subscapular, thoracodorsal, axillary, radial
Sensory region of axillary nerve
lateral and posterior shoulder
Sensory region of radial nerve
anterolateral forearm, posterolateral arm and forearm, posterolateral hand
Sensory region of musculocutaneous nerve
lateral forearm
Sensory region of median nerve
anterolateral palm, posterolateral fingertips
Sensory region of medial cutaneous nerve of the arm
medial arm
Sensory region of medial cutaneous nerve of the forearm
medial forearm
Sensory region of ulnar nerve
medial hand, posteromedial wrist
Median nerve runs with which structure
Brachial artery
What three structures run together in the medial aspect of the arm
median nerve, ulnar nerve, and brachial artery
Path of median nerve into forearm
cross elbow joint anteriorly, gives off a deep branch, enters hand through carpal tunnel
Deep branch of median nerve and where it begins
anterior interosseous nerve, forearm
Deep branch of the radial nerve and where it begins
posterior interosseous nerve, forearm
Injuries that can cause damage to axillary nerve
anterior dislocation of humerus, humeral surgical neck fracture
Injury that can cause damage to radial nerve
midshaft fracture of humerus
Injuries that commonly cause damage to median nerve
Epicondyle fracture, distal humerus fracture, carpal tunnel injuries
Branches of subclavian artery
Vertebral, internal thoracic, thyrocervical trunk, costocervical
Dividing line between subclavian and axillary arteries
lateral border of the first rib
Branches of first part of axillary artery
Superior thoracic
Branches of second part of axillary artery
Thoracoacromial, lateral thoracic
Branches of third part of axillary artery
Subscapular, anterior circumflex humeral, posterior circumflex humeral
Branches of subscapular artery
Circumflex scapular, thoracodorsal
Dividing line between axillary artery and brachial artery
Inferior border of teres major
Dorsal scapular nerve supplies
rhomboids, levator scapulae
Long thoracic nerve supplies
serratus anterior
Suprascapular nerve supplies
supraspinatus, infraspinatus
Lateral pectoral nerve supplies
Pectoralis major
Upper/Lower subscapular nerves supply
Subscapularis
Thoracodorsal nerve supplies
Latissimus dorsi
Medial pectoral nerve supplies
Pectoralis major, pectoralis minor
Medial cutaneous nerve of the arm supplies
Sensation to medial arm
Medial cutaneous nerve of the forearm supplies
Sensation to medial forearm
Musculocutaneous nerve ends as the
Lateral cutaneous nerve
Musculocutaneous nerve supplies
Anterior compartment of arm
Median nerve branches in forearm
Anterior interosseous nerve, palmar cutaneous nerve
Terminal branches of the ulnar nerve
Deep and superficial branches in hand
Axillary nerve innervates
Deltoid and teres minor
After penetrating ____ muscle, the radial nerve becomes the ________ nerve.
Supinator, posterior interosseous
Erb’s Palsy affects which roots
C5-C6
Causes of Erb’s Palsy
Birth injury, fall onto shoulder
Motor deficits associated with anterior interosseous syndrome
Can’t make OK sign, weakness of pronation and thumb flexion, loss of flexion at DIP joint of index and middle fingers
Injury causing anterior interosseous syndrome
Midshaft forearm fracture
Deformity of Erb’s Palsy
Arm hanging by side, internally rotated, adducted. Forearm extended and hand pronated
Disability of Erb’s Palsy
Cannot abduct or laterally rotate arm, no flexion or supination, sensory deficit over shoulder
Nerves affected by Erb’s Palsy
Musculocutaneous, axillary, suprascapular
Roots affected by Klumpke’s Palsy
C8, T1
Causes of Klumpke’s Palsy
Birth injury, over abduction of arm
Nerve affected by Klumpke’s Palsy
Ulnar
Deformity of Klumpke’s Palsy
Ulnar claw (hyperextension of MP joints and flexion of IP joints)
Disability of Klumpke’s Palsy
Loss of intrinsic hand muscles and ulnar flexors of wrist and fingers
Collateral circulation to the shoulder is provided by
Dorsal scapular, circumflex scapular, suprascapular, transverse cervical
Collateral circulation to the elbow is provided by
Ulnar collateral and radial collateral arteries, deep brachial artery
Collateral circulation to wrist/hand is provided by
Deep and superficial palmar arches
Test for infraspinatus and teres minor
External rotation
Test for subscapularis
Internal rotation, liftoff test
Test for supraspinatus impingement
Neer’s Sign
Test for rotator cuff pathology
Drop arm test
Test for impingement
Hawkin’s Test
Test for biceps tendinitis
Speed’s Test
Test for glenohumeral joint stability
Apprehension test
Test for supraspinatus strength
Empty can test