Upper Limb 1 Flashcards

1
Q

What is the axilla?

A

Pyramidal space below the shoulder joint
Provides passage way for vessels and nerves
Has an apex, base and 4 walls

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2
Q

What forms the anterior wall of the axilla?

A

Pectoralis major and pectoralis minor muscle

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3
Q

What forms the posterior wall of the axilla?

A

Subscapularis, teres major and latissimus dorsi

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4
Q

What forms the medial wall of the axilla?

A

Thoracic wall and serratus anterior muscle

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5
Q

What forms the lateral wall of the axilla?

A

Intertubercular sulcus of the humerus

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6
Q

What makes up the apex of the axilla?

A

Lateral border of first rib, superior border of scapula and posterior border of clavicle

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7
Q

What are the contents of the axilla?

A

Axillary artery, axillary vein, brachial plexus, axillary lymph nodes, and biceps brachii + coracobrachialis

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8
Q

What is the axillary artery a continuation of?

A

Subclavian artery

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9
Q

At what anatomical point does the axillary artery begin?

A

Lateral border of the 1st rib

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10
Q

When does the axillary artery change to the brachial artery?

A

Inferior border of teres major

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11
Q

When are axillary lymph nodes enlarged?

A

Infection of upper limb and malignant processes involving breast tissue

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12
Q

What ventral rami make up the brachial plexus?

A

C5 to T1

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13
Q

What is the nerve roots of the upper, middle and lower trunk of the brachial plexus?

A

Upper - C5 and C6
Middle - Continuation of C7
Lower - C8 and T1

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14
Q

What is the sub-divisions of the brachial plexus?

A

5 roots
3 trunks
3 anterior and 3 posterior divisions
3 cords
Terminal branches

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15
Q

What are the cords of brachial plexus named after?

A

Their position in relation to axillary artery in the axilla

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16
Q

What does injury to the upper trunk of brachial plexus cause?

A

Erb’s palsy - waiters tip appearance
Medial rotation of the arm with wrist flexion
Caused by hyperextension injury if head from shoulder

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17
Q

What does injury of the lower trunk of brachial plexus cause?

A

Klumpke’s palsy
Mainly affects intrinsic muscles of hand, flexor muscles of wrist and flexor muscles of fingers

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18
Q

What are the 5 main terminal branches of the cords of brachial plexus?

A

Axillary nerve
Radial nerve
Musculocutaneous nerve
Ulnar nerve
Median nerve

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19
Q

What nerves come from the posterior cord of the branchial plexus?

A

Axillary and radial nerves

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20
Q

What nerve comes from the lateral cord of the brachial plexus?

A

Musculocutaneous
Median nerve from lateral and medial cord

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21
Q

What nerves come from the medial cord of the brachial plexus?

A

Ulnar and Median nerve
Median nerve from medial and lateral cord

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22
Q

What are the roots of the musculocutaneous nerve?

A

C5-7

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23
Q

What are the roots of the axillary nerve?

A

C5 and C6

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24
Q

What are the roots of the median nerve?

A

C6-T1

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25
Q

What are the roots of the radial nerve?

A

C5-T1

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26
Q

What are the roots of the ulnar nerve?

A

C8-T1

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27
Q

What artery is number 3?

A

Subclavian artery

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28
Q

What artery is number 6?

A

Axillary artery

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29
Q

What artery is number 7?

A

Brachial artery

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30
Q

What artery is number 9?

A

Radial artery

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31
Q

What artery is number 10?

A

Ulnar artery

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32
Q

What vein is number 10?

A

Cephalic vein

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33
Q

What vein is number 11?

A

Basilic vein

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34
Q

What is number 12?

A

Median cubital vein

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35
Q

What is the dorsal venous arch?

A

Complex network of veins lying at the distal aspect of upper limb

36
Q

Where do superficial veins of upper limb lie?

A

Subcutaneous tissue - just under skin so easy access for some procedures

37
Q

Where does the cephalic and basilic veins arise from?

A

Cephalic - lateral end of the dorsal venous arch
Basilic - medial end of the dorsal venous arch

38
Q

Where is the median cubital vein situated?

A

Ante-cubital fossa

39
Q

Describe the course of the cephalic vein

A

Ascends in lateral aspect of arm and pierces clavipectoral fascia draining into axillary vein

40
Q

Describe the course of the basilic vein

A

Ascends on medial side of arm, passing deep at the mid-humeral level and becomes axillary vein at lower border of teres minor

41
Q

What is a dermatome?

A

Area of skin supplied by one spinal segment

42
Q

Where do all lymphatic vessels of upper limb drain into?

A

Axillary nodes

43
Q

What are the 5 distinct groups of axillary lymph nodes?

A

Anterior or pectoral group
Posterior or subscapular group
Apical group
Central group
Lateral or brachial group

44
Q

What is the pectoral gridle and what bones are included?

A

Connects the upper limb to the axial skeleton on each side
Scapula and clavicle with acromioclavicular and sternoclavicular joints

45
Q

What is the joint connecting the pectoral gridle to the upper arm?

A

Glenohumeral joint

46
Q

Name the features of the clavicle

A

Acromial end and Sternal end
Subclavian groove
Costal tuberosity
Trapezoid line
Conoid tubercle

47
Q

What can help differentiate between the acromial end and sternal end of the clavicle?

A

Lateral aspect of clavicle is flatter than medial
Superior surface is smoother than inferior
Conoid tubercle is attachment for conoid ligament - inferior aspect of lateral portion

48
Q

Which part of the clavicle is the weakest and breaks commonly during fall?

A

Middle as thinnest part of clavicle

49
Q

What is A?

A

Acromion of scapula

50
Q

What is B?

A

Coracoid process

51
Q

What is C?

A

Glenoid cavity

52
Q

What is D?

A

Subscapular fossa

53
Q

What is E?

A

Supraspinous fossa

54
Q

What is F?

A

Spine of the scapula

55
Q

What is G?

A

Supraglenoid tubercle

56
Q

What is H?

A

Infra-glenoid tubercle

57
Q

What is I?

A

Infra-spinous fossa

58
Q

What type of joint is the acromioclavicular joint?

A

Plane synovial joint

59
Q

What type of joint is the sternoclavicular joint?

A

Saddle synovial joint

60
Q

Describe the scapulo-humeral rhythm

A

First 30 degrees of abduction is caused by muscles acting on shoulder joint
After 30 degrees, relies on scapula being pulled upwards and laterally rotated on chest wall
Every 3 degrees of abduction after first 30 - 2 degrees occur at gleno-humeral joint and 1 at scapula thoracic movement

61
Q

What are the main muscles involved in elevation of scapula?

A

Trapezius
Levator scapulae

62
Q

What is the main muscle involved in depression of the scapula?

A

Trapezius

63
Q

What are the main muscles involved in protraction of the scapula?

A

Pectoralis minor and serratus anterior

64
Q

What are the main muscles involved in retraction of the scapula?

A

Trapezius and rhomboids

65
Q

What main muscle is involved in the lateral rotation of the scapula?

A

Trapezius - upper and middle

66
Q

What muscles are involved in the medial rotation of the scapula?

A

Gravity
Levator scapula
Rhomboid major and minor
Pectoralis minor

67
Q

What is muscle 1?

A

Trapezius

68
Q

What is muscle 2?

A

Levator scapula

69
Q

What is muscle 3?

A

Rhomboid minor

70
Q

What is muscle 4?

A

Rhomboid major

71
Q

What is muscle 5?

A

Supraspinatus

72
Q

What is muscle 6?

A

Infraspinatus

73
Q

What is muscle 7?

A

Teres minor

74
Q

What is muscle 8?

A

Teres major

75
Q

What is muscle 9?

A

Latissimus dorsi

76
Q

What are features of proximal humerus?

A

Head of humerus, greater + lesser tubercle, surgical neck, deltoid tuberosity and intertubercular groove

77
Q

Describe the glenoid cavity

A

On scapula
Is synovial ball and socket joint with humerus
Rim of cartilage surrounding socket is the glenoid labrum

78
Q

What is the function of the glenoid labrum?

A

Reduce disproportion

79
Q

What is ligament 10?

A

Transverse ligament

80
Q

What is ligament 8?

A

Glenohumeral ligaments - strengthen anterior aspect of joint capsule

81
Q

What is ligament 13?

A

Coraco-acromial ligament

82
Q

What is ligament 12?

A

Coracohumeral ligament - strengthens superior aspect of joint capsule

83
Q

What is the coraco-acromial arch made up of?

A

Acromion, coracoid and coraco-acromial ligament
Prevents superior displacement of humeral head

84
Q

What is the function of bursae?

A

Provide cushioning around joints via synovial fluid filled interior

85
Q

What are the 2 main bursae of shoulder?

A

Subacromial (subdeltoid) and subscapular bursae

86
Q

Which bursa communicates with the joint cavity?

A

Subacromial bursa

87
Q

What is the role of the subacromial bursa?

A

Reduces friction of tendon on movement of shoulder joint