upper extremity muscles Flashcards

1
Q

Pectoralis major?

Action?
Insertion?
Innervation?

A

Action :ADduct and medially rotate Humerus, protracts and depresses the Scapula,
Clavicular Head flexes the Humerus,
Sternocostal Head extends the Humerus from the flexed state

   Ins. Lateral edge Intertubercular Groove of Humerus

   I.Lateral and Medial Pectoral N
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2
Q

Pectoralis Minor?

Action?
Insertion?
Innervation?

A

A. Stabilizes Scapula by protracting and depressing it against the Thoracic Wall

 Ins. Coracoid Process of Scapula
 N.Medial Pectoral N
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3
Q

Subclavius ?

Action?
Insertion?
Innervation?

A

Positions and depresses the Clavicle

Ins.Anterior surface of Medial Border of the Scapula
N. Long Thoracic N

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4
Q

How and why does Paralysis of the Serratus Anterior M happen?

A

usually as a result of injury to the Long Thoracic N., results in “Winging” of the Scapula away from the Thoracic Wall, which makes abducting the upper limb beyond the horizontal position difficult

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5
Q

Deltoid ?

Action?
Insertion?
Innervation?

A
Anterior Part (Flex and Medially Rotate the Humerus) 
Middle Part (ABduct the Humerus) 
Posterior Part (Extend and Laterally Rotate the Humerus)

Ins: Deltoid Tuberosity of Humerus
N:Axillary N

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6
Q

Subscapluris?

Action?
Insertion?
Innervation?

A

Medially rotate and ADduct the Humerus,
holds the Humeral Head in the Glenoid Cavity

Ins: Lesser Tubercle of Humerus
N:Upper and Lower Subscapular N

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7
Q

Supraspinatus?

Action?
Insertion?
Innervation?

A

With the Deltoid M. ABduct the Humerus,
holds the Humeral Head in the Glenoid Cavity

         Ins.Greater Tubercle of Humerus
         N.Suprascapular N.
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8
Q

Infraspinatus?

Action?
Insertion?
Innervation?

A

.Laterally Rotates the Humerus, holds the Humeral Head in the Glenoid Cavity

          Ins. Greater Tubercle of Humerus
          N.Suprascapular N
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9
Q

Teres Minor
?

Action?
Insertion?
Innervation?

A

Laterally Rotates the Humerus, holds the Humeral Head in the Glenoid Cavity

         Ins. Greater Tubercle of Humerus
         N. Axillary N.
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10
Q

Teres Major?

Action?
Insertion?
Innervation?

A

ADduct and Medially Rotate the Humerus

        Ins. Medial edge of the Intertubercular Groove Humerus
        N.Lower Subscapular N
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11
Q

. Identify which of the Scapulohumeral muscles contribute to the Rotator Cuff and the describe the importance of that muscular element

A

The Supraspinatus, Infraspinatus, Teres Minor and Subscapularis Ms. are collectively referred to as the Rotator Cuff muscles and offer stability to the Glenohumeral Joint.

Trauma can injure or tear any of the Rotator Cuff muscles resulting in instability of the Glenohumeral Joint.

The Supraspinatus is the most commonly injured

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12
Q

Biceps Brachii?

Action?
Insertion?
Innervation?

A

Flex the Humerus,
Flex the supine Forearm and
Supinate the Forearm,
the Short Head resists dislocation of the Shoulder

   Ins. Radial Tuberosity and Antebrachial Fascia as the Bicipital Aponeurosis
  N.Musculocutaneous N
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13
Q

Coracobrachialis M

Action?
Insertion?
Innervation?

A

A.Flex and ADduct the Humerus

  Ins.Medial aspect of the Humeral Body

  N.: Musculocutaneous N
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14
Q

Brachialis M

Action?
Insertion?
Innervation?

A

A. Flex the Forearm

  Ins.Ulnar Tuberosity and Coronoid Process

  N.Musculocutaneous N
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15
Q

Triceps Brachii

Action?
Insertion?
Innervation?

A

Extend the Forearm, Long Head resist dislocation of the Shoulder

  Ins.Olecranon of Ulna and Antebrachial Fascia

  N.Radial N
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16
Q

Anconeus M

Action?
Insertion?
Innervation?

A

A.Extends the Forearm, Stabilizes the Elbow joint

Ins: olecranon
N.Radial N

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17
Q

What are the superficial forearm flexors?

A

Pronator Teres, Flexor Carpi Radialis, Palmaris Longus ,

Flexor Carpi Ulnaris

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18
Q

Pronator Teres

Action?
Insertion?
Innervation?

A

A.Pronate and Flex the Forearm
Ins: Lateral aspect of the Radius
N:Median N

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19
Q

Flexor Carpi Radialis

Action?
Insertion?
Innervation?

A

A. Flex Forearm, Flex and ABduct Hand at the Wrist

        Ins.Base of the 2nd Metacarpal
       N.Median N
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20
Q

Palmaris Longus

Action?
Insertion?
Innervation?

A

A. Flex Forearm, Flex Hand and Tenses the Palmar Aponeurosis

Ins.Palmar Aponeurosis, Flexor Retinaculum
N.Median N.

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21
Q

Flexor Carpi Ulnaris

Action?
Insertion?
Innervation?

A

A.Flex Forearm, Flex and ADduct Hand at the Wrist

       Ins.Pisiform, Hook of the Hamate and Base of the 5th Metacarpal
       N.Ulnar N
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22
Q

Flexor Digitorum Superficialis

Action?
Insertion?
Innervation?

A

A. Flex Forearm, Flex Hand at the Wrist, flex Proximal and Intermediate phalanges of
Digits 2-5 at the Metacarpophalangeal and Proximal Interphalangeal Joints respectively

       Ins. Bifed insertion on the Intermediate Phalanges of Digits 2-5
       N.Median N
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23
Q

What are the deep forearm flexors?

A

Flexor Digitorum Profundus, Flexor Pollicis Longus, Pronator Quadratus

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24
Q

Flexor Digitorum Profundus

Action?
Insertion?
Innervation?

A

Flex Hand at the Wrist, Flex all Phalanges of Digits 2-5 at the Metacarpophalangeal, Proximal and Distal Interphalangeal Joints

  Ins.   Bases of Distal Phalanges of Digits 2-5 (the tendon passes through    the bifed tendon for the Flexor Digitorum Superficialis M. to its insertion

N. Lateral Part: Anterior Interosseous N. (of the Median N.)
Medial Part: Ulnar N.

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25
Q

Flexor Pollicis Longus

Action?
Insertion?
Innervation?

A

A. Flex Hand, Flex and ABduct 1st Metacarpal at the 1st Carpometacarpal Joint, flex both
phalanges of the Pollux at the Intercarpal Joint

  Ins. Ventral aspect of the Base of Distal Phalanx of the Pollux

  N.: Anterior Interosseous N. (of the Median N.)
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26
Q

Pronator Quadratus

Action?
Insertion?
Innervation?

A

A. Pronate Forearm, deep fibers hold the Ulna and Radius together

  Ins.Anterior aspect of the distal Radius

  N.Anterior Interosseous N. (of the Median N.)
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27
Q

What are the superficial forearm extensors?

A
Brachioradialis M, 
Extensor Carpi Radialis Longus M, 
Extensor Carpi Radialis Brevis M, 
Extensor Digitorum M,
 Extensor Digiti Minimi M,
Extensor Carpi Ulnaris M.
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28
Q

Brachioradialis M.

Action?
Insertion?
Innervation?

A

I: Lateral aspect of the distal Radius

A: Flex Forearm (most force when Forearm is
Midpronated)

N: Radial N.

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29
Q

Extensor Carpi Radialis Longus M

Action?
Insertion?
Innervation?

A

I: Dorsal aspect of the Base of the 2nd Metacarpal

A: Extend and ABduct Hand at the Wrist (active during
fist clenching)

N: Radial N

30
Q

Extensor Carpi Radialis Brevis M

Action?
Insertion?
Innervation?

A

I: Dorsal aspect of the Base of 3rd Metacarpal
A: Extend and ABduct Hand at the Wrist
N: Deep Radial N.

31
Q

Extensor Digitorum M.

Action?
Insertion?
Innervation?

A

I: Extensor Expansions of Digits 2-5

A: Extend Hand at the Wrist, extend all Phalanges of
Digits 2-5 at the Metacarpophalangeal, Proximal and Distal
Interphalangeal Joints

N: Posterior Interosseous N.

32
Q

Extensor Digiti Minimi M

Action?
Insertion?
Innervation?

A

I: Extensor Expansion of Digit 5

A: Extend all phalanges of Digit 5 at the
Metacarpophalangeal, Proximal and Distal Interphalangeal
Joints

N: Posterior Interosseous N.

33
Q

Extensor Carpi Ulnaris M

Action?
Insertion?
Innervation?

A

I: Dorsal aspect of the Base of the 5th Metacarpal

A: Extend and ADduct Hand at the Wrist (active during
fist clenching)

N: Posterior Interosseous N

34
Q

Deep forearm extensors? what are they?

A
Supinator M, 
Extensor Indicis M,
 Abductor Pollicis Longus M, 
Extensor Pollicis Longus M,
Extensor Pollicis Brevis M.
35
Q

Supinator M?

Action?
Insertion?
Innervation?

A

I: Proximal aspect of the Radial Body

A: Supinate Forearm

N: Deep Radial N

36
Q

Extensor Indicis M?

Action?
Insertion?
Innervation?

A

I: Extensor Expansion of Digit 2

A: Extend Hand at the Wrist, Extend 2nd Digit

N: Posterior Interosseous N.

37
Q

Abductor Pollicis Longus M.

Action?
Insertion?
Innervation?

A

I: Base of the 1st Metacarpal

A: ABduct Hand at the Wrist, ABduct the Pollux at the
Carpometacarpal Joint

N: Posterior Interosseous N

38
Q

Extensor Pollicis Longus M

Action?
Insertion?
Innervation?

A

I: Dorsal aspect of the Base of the Distal Phalanx of the
Pollux

A: ABduct Hand at the Wrist, Extend 1st Metacarpal,
Proximal and Distal Phalanges of the Pollux at the
Carpometacarpal, Metacarpophalangeal and Interphalangeal
Joints

N: Posterior Interosseous N

39
Q

Extensor Pollicis Brevis M

Action?
Insertion?
Innervation?

A

I: Dorsal aspect of the Base of the Proximal Phalanx of the
Pollux

A: ABduct hand, Extend 1st Metacarpal and Proximal
Phalanges of the Pollux at the Carpometacarpal and
Metacarpophalangeal Joints

N: Posterior Interosseous N

40
Q

Muscles of the thenar eminence?

A

Abductor Pollicis Brevis M., Opponens Pollicis M,
Flexor Pollicis Brevis M,
Adductor Pollicis M

41
Q

Abductor Pollicis Brevis M

Action?
Insertion?
Innervation?

A

I: Lateral aspect of the Base of the Proximal Phalanx of the
Pollux

A: ABduct Pollux, aids in Opposition

N: Recurrent Branch of the Median N

42
Q

Opponens Pollicis M

Action?
Insertion?
Innervation?

A

I: Lateral aspect of the 1st Metacarpal

A: Oppose Pollux

N: Recurrent Branch of the Median N

43
Q

Flexor Pollicis Brevis M.

Action?
Insertion?
Innervation?

A

I: Lateral aspect of the Base of the Proximal Phalanx of the
Pollux

A: Flex 1st Metacarpal and Proximal Phalanges of the
Pollux at the Carpometacarpal and Metacarpophalangeal Joints

N: Superficial Head: Recurrent Branch of the Median N.
Deep Head: Deep Ulnar N

44
Q

Adductor Pollicis M

Action?
Insertion?
Innervation?

A

I: Medial aspect of the Proximal Phalanx of the Pollux
A: ADduct Pollux
N: Deep Ulnar N

45
Q

Hypothenar eminence

muscles?

A

Abductor Digiti Minimi M,
Flexor Digiti Minimi Brevis M,
Opponens Digiti Minimi M

46
Q

Abductor Digiti Minimi M

Action?
Insertion?
Innervation?

A

I: Medial aspect of the Base of the Proximal Phalanx of 5th Digit

A: ABduct 5th Digit

N: Deep Ulnar N

47
Q

Flexor Digiti Minimi Brevis M

Action?
Insertion?
Innervation?

A

I: Medial aspect of the Base of the Proximal Phalanx of 5th Digit

A: Flex Proximal Phalanx of 5th Digit

N: Deep Ulnar N

48
Q

Opponens Digiti Minimi M

Action?
Insertion?
Innervation?

A

I: Medial aspect of the 5th Metacarpal

A: Oppose 5th Digit

N: Deep Ulnar N

49
Q

1st and 2nd Lumbrical M

Action?
Insertion?
Innervation?

A

I: Radial aspect of the Extensor Expansions of the 2nd and 3rd Digits

A: Flex Proximal Phalanges of the 2nd and 3rd Digits at the
Metacarpophalangeal Joint, Extend Intermediate and Distal
Phalanges of the 2nd and 3rd Digits by tightening extensor
expansion

N: Median N

50
Q

3rd and 4th Lumbrical M

Action?
Insertion?
Innervation?

A

I: Radial aspect of the Extensor Expansions of the 4th and 5th Digits

A: Flex Proximal Phalanges of the 4th and 5th Digits at the
Metacarpophalangeal Joint, Extend Intermediate and Distal
Phalanges of the 4th and 5th Digits by tightening extensor
expansion

N: Deep Ulnar N

51
Q

Dorsal Interossei M

Action?
Insertion?
Innervation?

A

I: Bases of Proximal Phalanges and Extensor Expansion of
Digits 2-4

A: ABduct Digits 2-4, flex Proximal Phalanges at the
Metacarpophalangeal Joint, Extend Intermediate and Distal
Phalanges by tightening extensor expansion

N: Deep Ulnar N

52
Q

Palmar Interossei M. (1-3) PAD

Action?
Insertion?
Innervation?

A

I: Bases of Proximal Phalanges and Extensor Expansions
of the 2nd, 4th and 5th Digits

A: ADduct 2nd, 4th and 5th Digits, flex Proximal Phalanges
of the 2nd, 4th and 5th Digits at the Metacarpophalangeal Joint,
Extend Intermediate and Distal Phalanges of the 2nd, 4th and 5th
Digits by tightening extensor expansion

N: Deep Ulnar N

53
Q

what is winging of the scapula?

A

Paralysis of the Serratus Anterior M., usually as a result of injury to the Long Thoracic N., results in “Winging” of the Scapula away from the Thoracic Wall, which makes abducting the upper limb beyond the horizontal position difficult

54
Q

what are the boundaries of the triangular space?

A

Borders:

superior: Teres Minor M.,
inferior: Teres Major M.
lateral: Long Head of the Triceps Brachii M.

55
Q

contents of triangular space?

A

Circumflex Scapular A. and V

56
Q

what are the boundaries of the Quadrangular Space?

A

Borders:
Superior: Teres Minor M.,
Inferior: Teres Major M.,
Medial: Long and Lateral Heads of the Triceps Brachii M.

57
Q

what are the boundaries of the triangular interval?

A

teres major - superior

long head of the triceps brachii - medial

Contents: Deep Brachial A. and V., and Radial N

58
Q

Explain the Bicipital Myotactic Reflex

A

Striking the thumb placed over the Bicipital Tendon with a reflex hammer should produce a Bicipital Myotactic Reflex, failure of the tendon to tighten up and the Forearm to flex slightly could suggest injury to the Musculocutaneous N. or C5 and C6 Anterior Rami

59
Q

Describe the relationship between the Long Head of the Biceps Brachii M. and the Intertubercular Groove of the Humerus and conditions that may arise from this relationship

A

Repetitive movement of the Long Head of the Biceps T. through the Intertubercular Groove makes that tendon susceptible to inflammation, known as Biceps Tendinitis, and even Crepitus, a crackling sound.

Furthermore that tendon is capable of dislocating out of the Intertubercular Groove or even separating entirely from the Supraglenoid Tubercle, which results in the muscle balling up in the mid arm, a condition known as “Popeye Deformity.”

60
Q

. Describe the anatomical structures associated with the condition known as “tennis elbow

A

Repetitive use of the Superficial Extensor muscles of the Forearm can result in Elbow Tendinitis, or “Tennis Elbow,” and involves pain over the Lateral Epicondyle and down the posterior Forearm. Repeated flexion and extension of the Wrist strains the Periostium of the Lateral Humeral Epicondyle, called Lateral Epicondylitis.

61
Q

Draw the Anatomical Snuff Box, identifying its borders and contents

A

Lateral (anterior) border: Abductor Pollicis Longus M. and Extensor Pollicis
Brevis M.

Medial (posterior) border: Extensor Pollicis Longus M.

Contents: Radial A. (deep to tendons) and Superficial Radial N. (superficial to
tendons)

62
Q

Describe opposition of the Thumb and explain how the joints and musculature lead to this complicated actio

A

The complicated action of opposition of the thumb can be lost with injury to the Median N. Even a very superficial injury of the palm can damage the recurrent branch of the Median N. which innervates the muscles involved in opposition

63
Q

Power Grip (Palm Grasp)?

A

Digits acting against the Palm while wrapped
around an object with counterpressure from the Pollux, includes involvement from the
long flexors of the digits acting at the Interphalangeal joint with Intrinsic Hand Muscles
acting at the Metacarpophalangeal Joint

64
Q

Hook Grip?

A

As when carrying a suitcase, consumes less energy than the
power Grip, involves mainly the long flexors of the digits acting at the Interphalangeal
Joint

65
Q

Precision Handling Grip?

A

As when writing, involves long flexor and extensor

muscles in addition to the Intrinsic Hand muscles performing fine movements

66
Q

Pinching?

A

compressing an object between the distal aspect of the 1st and 2nd
Digits

67
Q

Position of Rest?

A

inactive position

68
Q

. Explain the “extensor expansion” on the dorsum of the digits, its mechanism of action and its importance in the function of the Hand

A

The tendons of the extensor digitorum flatten as they reach the metacarpals and become extensor expansions (or hoods) which fan out and wrap around the metacarpal and proximal phalanx joining onto the palmar plate. This extensor expansion spreads out further distally into a median band which attaches to the middle phalanx and two lateral bands which attach to the distal phalanx. Contraction of the extensor digitorum muscle tightens this tendon which acts on these attachments and extends the fingers.

69
Q

Flexor Retinaculum

A

This thick strip of connective tissue forms the roof of the carpal tunnel, protecting the structures within it. It attaches medially to the pisiform and hook of hamate, and laterally to the trapezium and scaphoid

70
Q

Extensor Retinaculum

A

This thickening of the fascia on the dorsum of the hand keeps the extensor tendons in position, preventing bowstringing

71
Q

. Describe the causes and clinical consequences of Supraspinatus Impingement Syndrome

A

The space between the acromion process and the head of the humerus is occupied by bursa and the supraspinatus tendon. In supraspinatus impingement syndrome the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space, the passage beneath the acromion. This can result in pain, weakness and loss of movement at the shoulder

72
Q

3 types of supraspinatus impingement?

A

Type I - mild impingement
Type II- Curved acromion process
Type III- hooked acromion process, most severe