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Yr 3 MSK > Upper limb 1+2 anatomy > Flashcards

Upper limb 1+2 anatomy Flashcards

consolidate knowledge of anatomy

1
Q

What is the axilla?

A

Pyramidal space below shoulder joint providing passage for vessels/nerves to upper limb

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2
Q

What makes up the following walls of axilla?

  • Anterior wall
  • Posterior wall
  • Medial wall
  • Lateral wall
A

Anterior: pectoralis major/minor
Posterior: scapularis muscle
Medial: thoracic wall and serratus anterior
Lateral: intertubular sulcus of humerus

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3
Q

The axillary artery is a continuation of what artery?

A

Subclavian artery

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4
Q

What anatomical point does axillary artery begin?

A

Midpoint of clavicle

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5
Q

What anatomical point does axillary artery become brachial artery?

A

Lower border of teres major

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6
Q

What ventral rami form the brachial plexus?

A

C5-T1

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7
Q

What nerve roots form the superior trunk of brachial plexus?

A

C5 and 6

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8
Q

What is Erbs point?

A

Point where C5 and 6 join together. Injury here (eg at birth/from fall on shoulder) results in Erbs palsy, which can result in biceps brachii/brachialis/coracobrachialis/brachioradialis/deltoid being affected

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9
Q

What segmental roots form inferior (medial) trunk of brachial plexus?

A

C8 and T1

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10
Q

Injury to the inferior trunk of brachial plexus results in Klumpke’s palsy. What is the injury cause and what muscles are affected?

A

Undue abduction of arm is cause.

Intrinsic muscles of hand and ulnar flexors of wrist/fingers are affected

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11
Q

What is the superior/middle/inferior trunks of the brachial plexus when named by their respective cords?

A
  • Lateral cord (C5 and 6)
  • Posterior cord (C7)
  • Medial cord (C8 and T1)
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12
Q

What are the branches of the lateral cord of brachial plexus?

A
  • Lateral pectoral nerve
  • Lateral root of median nerve
  • Musculocutaneous nerve
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13
Q

What are the branches of the posterior cord of brachial plexus?

A
  • Thoracodorsal nerve
  • Axillary nerve
  • Ulnar nerve
  • Subscapular nerve
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14
Q

What are the branches of the medial cord of brachial plexus?

A
  • Medial pectoral nerve
  • Radial nerve
  • Medial branch of median nerve
  • Medial cutaneous nerve of arm
  • Medial cutaneous nerve of forearm
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15
Q

How does the veins of the hand form from the dorsal venous arch?

A
  • Basilic vein forms laterally from dorsal venous arch

- Cephalic vein forms medially from dorsal venous arch

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16
Q

Where do lymphatic vessels from upper limb drain into?

A

Axillary lymph nodes`

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17
Q

Could infection around umbilicus spread to both axillary and superficial inguinal groups of both sides? If so why?

A

Yes - lymphatic system drains up and down around umbilicus

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18
Q

What is the function of pectoral/shoulder girdle?

A

Connect upper limb to axial skeleton on each side

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19
Q

What is the only articulating joint between the upper limb and pectoral girdle? What type of joint is this?

A

Acromioclavicular joint. Synovial plane joint

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20
Q

Where is weakest point point of the clavicle and is most commonly broken during a fall with an outstretches hand?

A

1/3 from acromial end. Thinnest part of clavicle

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21
Q

What type of joint is the sternoclavicular joint?

A

Synovial saddle

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22
Q

Where does the head of humerus attach to the scapula bone?

A

Glenoid cavity

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23
Q

What muscles are responsible for ELEVATION of the scapula?

A
  • Levator scapulae

- Upper fibres of trapezius

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24
Q

What muscles are responsible for DEPRESSION of the scapula?

A
  • Pectoralis minor
  • Lower fibres of trapezius
  • Subclavius
  • Latissimus dorsi
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25
Q

What muscles are responsible for PROTRACTION (forward movement) of the scapula?

A
  • Serratus anterior
  • Pectoralis major
  • Pectoralis minor
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26
Q

What muscles are responsible for RETRACTION (backward movement) of the scapula?

A
  • Trapezius (middle fibres)
  • Rhomboid major
  • Rhomboid minor
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27
Q

What muscles are responsible for LATERAL ROTATION (elevating glenoid cavity) of the scapula?

A
  • Infraspinatus

- Teres minor

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28
Q

What muscles are responsible for MEDIAL ROTATION (depressing glenoid cavity) of scapula?

A
  • (Gravity)
  • Levator scapulae
  • Rhomboid major
  • Rhomboid minor
  • Pectoralis minor
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29
Q

What type of joint is the glenohumeral joint (shoulder joint)?

A

Synovial ball and socket

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30
Q

What is the rim of cartilage surrounding the glenoid cavity? What is its function?

A

Glenoid labrum. Acts to deepen the joint helping to keep it in place

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31
Q

What are the ligaments of the shoulder? What do they attach to?

A

-Joint capsule - Attaches to head of humerus and superior part of the rim of glenoid cavity. Surrounds joint
Coracohumeral ligament - attaches to head of humerus and coracoid process
Coracoclavicular ligament - attaches to coracoid process and clavicle
Coracoacromial ligament - attaches to acromion and coracoid process
Glenohumeral ligament - attaches to head of humerus and glenoid cavity
Transverse humeral ligament - attaches in intertubercular sulcus of humerus

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32
Q

What do the glenohumeral ligaments do?

A

Act to strengthen the inferior aspect of joint capsule

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33
Q

What does the coracohumeral ligament do?

A

Act to strengthen superior aspect of joint capsule

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34
Q

What is the coracoacromial arch made up of and what does it prevent?

A
  • Acromion and coracoid process of scapula, and coracoacromial ligament
  • Acts to prevent superior displacement of humeral head
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35
Q

What part of the shoulder joint capsule is weakest due to not being protected by ligaments and muscles? therefore what type of shoulder dislocation is most common?

A

Beneath head of humerus on anterior side. Therefore ANTERIOR dislocation is most common

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36
Q

What is the function of bursa at joints?

A

Provide cushioning via their fluid filled interior

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37
Q

What bursa communicates with joint cavity?

A

Subscapular bursa. Seen when looking at coronal view of glenoid cavity. Surrounds it

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38
Q

What is the role of the subacromial bursa?

A

Facilitate gliding of tendons over the bone

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39
Q

What common sporting injury damages the subacromial bursa?

A

Subacromial bursitis

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40
Q

What are the rotator cuff muscles?

A
  • Subscapularis (anterior side)
  • Supraspinatus
  • Infraspinatus
  • Teres minor
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41
Q

The rotator cuff muscles extend from the scapula to humerus. What movements of the glenohumeral joint do they evoke? Is there any other functions at this joint the muscles have?

A

Internal/external rotation. Stablising joint

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42
Q

Where does the deltoid insert?

A

From the lateral spine of the scapula, across acromion, to lateral third of clavicle

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43
Q

The deltoid has anterior, middle and posterior fibres, with different movements for each set of fibres. What are the movements each of these evoke?

A

Anterior: flexes and medially rotates at shoulder joint
Middle: abduct at shoulder joint
Posterior: extends and laterally rotates

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44
Q

What nerve innervates the deltoid?

A

Axillary nerve (C5, C6)

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45
Q

What nerve innervates teres minor?

A

Axillary nerve (C5, C6)

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46
Q

What nerve innervates subscapularis, supraspinatus and infraspinatus?

A
  • Subscapularis: subscapular nerves
  • Supraspinatus: suprascapular nerve
  • Infraspinatus: suprascapular nerve
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47
Q

What common shoulder injury leads to the axillary nerve becoming trapped?

A

Shoulder dislocation

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48
Q

Where do the fibres of the pectoralis major originate?

A

Medial third of clavicle, sternum and ribs

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49
Q

What is the action(s) of the pectoralis major at the glenohumeral (shoulder) joint?

A

Adduction and internal rotation

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50
Q

What is the action(s) of serratus anterior?

A

Protraction of scapula. Stabilise scapula during limb movements

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51
Q

What nerve innervates the serratus anterior?

A

Long thoracic nerve (C5, C6, C7)

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52
Q

What clinical sign can arise if injury to long thoracic nerve (and therefore paralysing serratus anterior) occurs?

A

Winged scapula (retracted scapula position)

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53
Q

During what procedure is long thoracic nerve commonly injured?

A

Mastectomy

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54
Q

The trapezius has superior, middle and inferior fibres. What do each of these do?

A

Superior fibres: elevate scapula
Middle fibres: retract scapula
Inferior fibres: depress scapula

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55
Q

What nerve innervates trapezius?

A

Accessory nerve (CN XI)

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56
Q

What are the action(s) of teres major on shoulder joint?

A
  • Adduction

- Internal rotation

57
Q

What are the action(s) of latissimus dorsi on shoulder joint?

A
  • Adduction
  • Extension
  • Internal rotation
58
Q

What muscles are involved in FLEXION of shoulder joint?

A
  • Anterior part of deltoid
  • Coracobrachialis
  • Pectoralis major
  • Biceps brachii
59
Q

What muscles are involved in EXTENSION of shoulder joint?

A
  • Long head of triceps brachii
  • Posterior part of deltoid
  • Latissimus dorsi
60
Q

What muscles are involved in ADDUCTION of shoulder joint?

A
  • Subscapularis
  • Teres major
  • Latissimus dorsi
  • Pectoralis major
61
Q

What muscles are involved in ABDUCTION of shoulder joint?

A
  • Middle part of deltoid

- Supraspinatus

62
Q

What muscles are involved in INTERNAL ROTATION of shoulder joint?

A
  • Subscapularis
  • Latissimus dorsi
  • Pectoralis major
  • Teres major
63
Q

What muscles are involved in EXTERNAL ROTATION of shoulder joint?

A
  • Teres minor

- Infraspinatus

64
Q

What are the three important muscles of the anterior compartment of the forearm?

A
  • Biceps brachii
  • Coracobrachialis
  • Brachialis
65
Q

The biceps brachii has two heads arising from the scapula, uniting at the distal third of upper arm, forming a a short tendon. Which of the two heads (long and short head) arise from the coracoid process along with coracobrachialis?

A

Short head

66
Q

Which head of the biceps brachii arises from supraglenoid tubercle (above glenoid cavity) and runs in bicipital groove of humerus?

A

Long head

67
Q

Which bony process of radius does tendon of biceps attach distally?

A

Radial tuberosity

68
Q

What is the action of biceps brachii on:

  • Shoulder and elbow joint
  • Superior radio-ulnar joint?
A
  • Shoulder and elbow joint: Abduction

- Superior radio-ulnar joint: Supination

69
Q

What is the nerve supply to biceps brachii?

A

Musculocutaneous nerve

70
Q

What segmental fibres mainly innervate biceps brachii?

A

C5-C7

71
Q

From which cord of brachial plexus does musculocutaneous nerve arise?

A

Lateral cord

72
Q

What is the insertion for the coracobrachialis?

A

From tip of coracoid process to medial margin of humerus at about its middle

73
Q

What is the action of coracobrachialis on the shoulder joint?

A

Adduction

74
Q

What nerve supplies the coracobrachialis?

A

Musculocutaneous nerve

75
Q

What is the insertion of the brachialis?

A

Arises from front of the distal half of humerus shaft and inserts into coronoid process of ulna

76
Q

What is the main action of brachialis on elbow joint?

A

Flexion

77
Q

What nerve supplies the brachialis?

A

Musculocutaneous nerve

78
Q

The musculocutaneous nerve is the main nerve of the anterior arm compartment. What is the course of this nerve in the arm?

A

Perforates coracobrachialis and descends between biceps and brachialis

79
Q

What does the musculocutaneous nerve continue as after supplying the anterior arm muscles?

A

Lateral cutaneous nerve of forearm

80
Q

What is the segmental root value of the musculocutaneous nerve?

A

C5-C7

81
Q

List the 3 muscles supplied by musculocutaneous nerve

A
  • Biceps brachii
  • Coracobrachialis
  • Brachialis
82
Q

If someone sustained an injury via a weapon to the axilla area, what would be the result of the injury to musculocutaneous nerve?

A
  • Paralysis of biceps brachii, coracobrachialis, brachialis

- Loss of sensation to lateral aspect of forearm

83
Q

When does the subclavian artery become the axillary artery?

A

Outer border of first rib

84
Q

When does axillary artery become brachial artery?

A

Lower border of teres major

85
Q

Where does brachial artery divide into radial and ulnar artery?

A

In cubital fossa close to neck of radius

86
Q

What is one of the main arteries branching off the brachial artery?

A

Profunda brachii (deep artery of arm)

87
Q

What two cords does the median nerve arise from?

A

Lateral and medial cords

88
Q

How does the median nerve travel in the arm?

A

Descends along lateral side of axillary artery and upper part of brachial artery, and in middle of arm it crosses to medial side of brachial artery entering cubital fossa

89
Q

Does the median nerve supply any muscles in arm?

A

No, supplies muscles in hand

90
Q

What cord of brachial plexus does ulnar nerve arise from?

A

Medial cord

91
Q

How does the ulnar nerve descend in the arm?

A

Descends along medial side of brachial artery and enters posterior compartment of arm through intermuscular septum. Runs along medial head of triceps and to back of medial epicondyle

92
Q

Does ulnar nerve innervate any muscles in arm?

A
  • Flexor carpi ulnaris

- Medial half of flexor digitorum profundus

93
Q

What are 3 common sites on the humerus where damage to these three nerves are likely due to fracture?

  • Radial nerve
  • Ulnar nerve
  • Axillary nerve
A
  • Radial nerve: radial groove
  • Ulnar nerve: medial epicondyle
  • Axillary nerve: surgical neck
94
Q

How do you tell if you are looking at the left or right arm using brachial artery/biceps tendon/median cubital vein?

A

-Brachial artery is more medial than biceps tendon. Also median cubital vein points diagonally away from the body to the lateral side where the cephalic vein is

95
Q

What is the pulse that can be felt medial to the tendon of biceps brachii?

A

Brachial pulse (of brachial artery)

96
Q

What is the base of the cubital fossa made up of?

A

Imaginary line made up by two epicondyles

97
Q

What muscle makes up the medial border of the cubital fossa?

A

Pronator teres

98
Q

What muscle makes up lateral border of cubital fossa?

A

Brachioradialis

99
Q

What are the contents of the cubital fossa?

A
  • Terminal part of brachial artery and commencement of radial/ulnar arteries
  • Biceps brachii tendon
  • Median nerve
  • Radial nerve +superficial/deep branches
100
Q

Where is the brachial artery in relation to the median nerve and biceps brachii tendon in the cubital fossa?

A

In between them both. Median nerve runs medially to the brachial artery

101
Q

The triceps has a long head and two shorter heads (lateral and medial). Where do each of these heads arise from?

A
  • Long head: infraglenoid tubercle of scapula

- Lateral and medial heads: humerus

102
Q

Where does the common tendon of triceps insert into?

A

Olecranon process of ulna

103
Q

What is the main action of triceps on elbow joint?

A

Extension

104
Q

What is the action of the anconeus muscles on the elbow joint?

A

Extension, stabilisation of joint

105
Q

What type of muscles does the radial nerve innervate of the arm?

A

All extensor muscles of elbow and wrist joint

106
Q

The radial nerve is a terminal branch of what cord of brachial plexus?

A

Posterior cord

107
Q

Where does radial nerve enter the arm?

A

Anterior to long head of triceps, running with profunda femoris artery (deep artery of arm), curving around midshaft region of humerus in radial groove WITH the deep brachial artery

108
Q

What is the root value of radial nerve?

A

C5-T1

109
Q

What would the characteristic sign of a radial nerve injury be and where is the most common place for fracture?

A

Midshaft humeral fracture, can’t straighten arm

110
Q

What type of joint is the elbow joint?

A

Synovial hinge

111
Q

List the articular parts of the elbow joint

A

Trochlea, capitulum, trochlear notch, coronoid process, olecranon process, head of radius

112
Q

What movements occur at elbow joint?

A

Flexion, extension

113
Q

How are the ligaments of the elbow formed?

A

Thickening of the fibrous layer of joint capsule on medial and lateral side

114
Q

What are the two collateral ligaments of the elbow?

A
  • Radial collateral ligament

- Ulnar collateral ligament

115
Q

What ligament holds the head of radius?

A

Annular ligament

116
Q

What are the flexors of the elbow joint?

A
  • Brachialis
  • Biceps brachii
  • Brachioradialis
117
Q

What are the extensors of the elbow joint?

A
  • Triceps brachii

- Anconeus

118
Q

What is olecranon bursitis otherwise known as?

A

Student elbow

119
Q

What type of joint are the proximal and distal radioulnar joints?

A

Synovial pivot joint

120
Q

What movements occur at the radioulnar joints?

A

Supination, pronation

121
Q

What is subluxation?

A

Partial dislocation of joint

122
Q

What are the main muscles in supination at radio-ulnar joint?

A
  • Supinator

- Brachioradialis

123
Q

What are the main muscles in pronation at radioulnar joint?

A
  • Pronator teres

- Pronator quadratus

124
Q

What are muscles that assist in supination other than supinator/brachioradialis?

A
  • Extensor pollicis longus
  • Extensor carpi radialis longus
  • Biceps brachii (long head)
125
Q

What are muscles that assist in pronation other than pronator teres/quadratus?

A
  • Flexor carpi radialis
  • Palmaris longus
  • Brachioradialis
126
Q

What is the strongest supinator and pronator of arm?

A
  • Supinator: supinator muscle

- Pronator: Pronator teres

127
Q

What is the innervation of teres minor?

A

Axillary nerve

128
Q

What movement of shoulder occurs when infraspinatus contracts?

A

Lateral rotation

129
Q

What is the action of serratus anterior?

A

Protraction of scapula

130
Q

What nerve innervates serratus anterior?

A

Long thoracic nerve

131
Q

What are two actions of long head of biceps brachii?

A
  • Flexion at shoulder

- Supination at radioulnar joint

132
Q

What nerve innervates biceps brachii?

A

Musculocutaneous nerve

133
Q

What type of joint is acromioclavicular joint?

A

Synovial plane

134
Q

What muscles insert into greater tubercle of humerus?

A
  • Supraspinatus
  • Infraspinatus
  • Teres minor
135
Q

What nerve is closely related to medial epicondyle?

A

Ulnar nerve

136
Q

What are the actions of latissimus dorsi on shoulder joint?

A
  • Extension
  • Medial rotation
  • Adducts
137
Q

What are the actions of the middle fibres of deltoid?

A

Abduct scapula

138
Q

What spinal segments innervate deltoid?

A

C5 and C6

139
Q

The subacromial bursa is associated with with muscle?

A

Supraspinatus

Yr 3 MSK (12 decks)

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