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MSK > Upper Limb 1 > Flashcards

Upper Limb 1 Flashcards

1
Q

What forms the lateral side of the axillary pyramid

A

The intertubercular groove of the humerus

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2
Q

What forms the posterior wall of the axilla

A

The subscapularis
Pectoralis minor
Latissmus dorsi

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3
Q

What forms the anterior side of the axillary pyramid

A

Pectoralis major

Subclavius

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4
Q

What forms the medial side of the axillary pyramid

A

Intercostal muscles and ribs

Seratus anterior

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5
Q

What forms the top of the axillary pyramid

A
  • lateral border of first rib
  • superior border of scapula
  • posterior border of clavicle
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6
Q

Which nerve roots converge to form the upper trunk of the brachial plexus

A

C5 and C6

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7
Q

What nerve(s) form(s) the middle trunk of the brachial plexus

A

C7

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8
Q

What nerves converge to form the lower trunk of the brachial plexus

A

C8 and T1

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9
Q

Which muscles is the brachial plexus roots in between

A

Posterior and anterior scalene muscles

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10
Q

What forms the brachial plexus

A

VENTRAL RAMI OF C5, C6, C7, C8 and T1

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11
Q

Which cord in relation to the axillary artery gives rise to the musculocutaneous nerve

A

Lateral

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12
Q

Root value of the lateral cord of the brachial plexus

A

C5, C6 and C7

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13
Q

What does the median nerve arise from

A

The lateral and medial cords

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14
Q

Which nerves does the posterior cord of the brachial plexus give rise to

A

Axillary and radial nerves

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15
Q

Which cord does the ulnar nerve arise from

A

The medial cord

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16
Q

How would you cause erb’s palsy

A

injury to the upper trunk
Hyperextension of neck from shoulder
Falling on shoulder, birth injury or during anaesthesia

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17
Q

What would cause klumpke’s palsy

A

Injury at the nerve roots C8 and T1 - falling from a tree

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18
Q

Symptoms of erb’s palsy

A

Waiter’s tip

Medially rotated with wrist flexed

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19
Q

Which muscles are supplied by nerve roots C5 and C6

A

The upper trunk

  • Supraspinatus, infraspinatus,
  • Biceps brachi, coracobrachialis, deltoid, teres minor
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20
Q

Which muscles are affected by klumpke’s palsy

A

Intrinsic muscles of the hand and ulnar flexors of the wrist and fingers

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21
Q

What are the main branches of the brachial plexus

A 
Musculocutaneous 
Axillary 
Radial 
Median 
Ulnar
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22
Q

Which nerve runs closest with the brachial artery

A

The median nerve

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23
Q

When does the subclavian artery change into the axillary artery

A

Lateral border of the first rib

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24
Q

Main contributor of the deep palmar arch

A

Radial artery

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25
Q

Main contributor of superficial palmar arch

A

Ulnar artery

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26
Q

Which of these veins is more lateral
- cephalic or basilic

Which vein connects these 2 veins

A

Cephalic

Median cubital vein

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27
Q

Where does the median cubital vein shunt blood to and from

A

From the cephalic vein to the basilic vein

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28
Q

What are the distinct groups of axillary lymph nodes

A
  • Anterior/pectoral
  • Posterior/subscapular
  • Apical
  • Central
  • Lateral
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29
Q

Where would an infection from the little finger spread

A

Lateral group of lymph nodes

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30
Q

Where would an infection in the scapular region spread to

A

Posterior/subscapular group of lymph nodes

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31
Q

Where would the upper medial quadrant of the breast drain to

A

Anterior group of lymph nodes

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32
Q

Where do the upper limb and pectoral girdle articulate with the axial skeleton

A

Sternoclavicular joint

33
Q

Where is the easiest place to break the clavicle

A

Junction between middle 1/3 and lateral 1/3

34
Q

What muscles attach to the coracoid process

Originate from?

A 
Biceps brachi (short head)
Pectoralis minor

Coracobrachialis

35
Q

Which bone does the acromion of the scapula articulate with

A

The clavicle

–> acromioclavicular joint

36
Q

What type of joint is the acromioclavicular joint

A

Synovial plane

37
Q

What type of joint is the sternoclavicular joint

A

Synovial saddle

38
Q

Which muscles elevate the scapula

A
  • Trapezius - superior part

- levator scapulae

39
Q

Which muscles depress the scapula

A

Trapezius - inferior part

40
Q

Which muscle protracts the scapula

A

Serratus anterior

41
Q

Which muscle retracts the scapula

A

Trapezius (middle) and rhomboids

42
Q

Which muscles rotate the scapula to elevate the glenoid cavity
(- after the first 30 degrees of movement occurring at the glenohumeral joint)

A

Descending and ascending trapezius work together??

43
Q

Which muscles rotate the scapula to depress the glenoid cavity
(- after the first 30 degrees of movement occurring at the glenohumeral joint)

A

Inferior trapezius and inferior part of serratus anterior

44
Q

Why is the glenohumeral joint stable despite the humerus being much larger than the glenoid fossa

A

The glenoid fossa is deepened by a fibrocartilaginous rim called the glenoid labrum

45
Q

Name the ligaments of the glenohumeral joint

A
  • coracohumeral ligament
  • coracoacromial ligament
  • glenohumeral ligaments
46
Q

What prevents upper displacement of the humeral head from the glenoid fossa

A

The coracoacromial arch made up of the acromion and coracoid process of the scapula and the coracoacromial ligament

47
Q

Which part of the shoulder joint is weakest

A

Anterior - is not protected by muscles or ligaments

48
Q

Name the bursae around the shoulder joint

A
  • subacromial

- subscapular

49
Q

What is the role of the subacromial bursa

A

Supports deltoid and supraspnatous muscles

50
Q

Where is the subacromial bursa

A

Inferior to the deltoid and acromion and superior to the supraspnatous tendon and joint capsule

51
Q

Which bursa is located between the subscapularis tendon and the scapula

A

Subscapular bursa

52
Q

Name the rotator cuff muscles

A

Supraspinatous
Infraspinatus
Teres minor
Subscapularis

53
Q

What is the function of the rotator cuff muscles

A

Hod the humeral head in the glenoid cavity of scapula during all movements of the shoulder

54
Q

What movements of the glenohumeral joint are initiated by the rotator cuff muscles

A

Subscapularis, teres minor and infraspinatus all involved in rotation

Supraspinatous involved in abduction of the arm

55
Q

What is the origin of the deltoid muscle

A

Lateral spine of the scapula across the acromion to the lateral third of the clavicle

56
Q

Action of the anterior fibres of the deltoid

A

Flexes and medially rotates at the shoulder joint

57
Q

Action of the middle fibres of the deltoid

A

Abduction at the shoulder joint

58
Q

Action of the posterior fibres of the deltoid

A

Extension and lateral rotation at the shoulder joint

59
Q

Which nerve supplies the deltoid muscle

A

Axillary

60
Q

Which nerve is at risk from a surgical neck of humerus fracture

A

Axillary nerve

61
Q

Where would you test for loss of sensation for the axillary nerve

A

Lateral side of the arm over the deltoid area

- dermatomes C5 and C6

62
Q

Where do the fibres of the pectoralis major originate

A

Medial third of clavicle, the sternum and ribs

63
Q

Action of the Pectoralis major on the shoulder joint

A

To adduct and medially rotate the humerus

64
Q

Which vein is found in the deltopectoral triangle

A
  • this is the space between the deltoid and pectoralis major muscle
  • subclavian
65
Q

Action of the serratus anterior

A
  • Protraction of the scapulae

- stabilises the scapulae during limb movements to keep it pulled against the thoracic cage

66
Q

What is the nerve supply to the serratus anterior muscle

A

Long thoracic nerve - C5, C6 and C7

67
Q

What clinical sign is viewed when the long thoracic nerve is damaged

A

Winging of the scapulae

68
Q

During what procedure is the long thoracic nerve at risk of damage

A
  • Radical mastectomies
  • Also become damage by damage to the shoulder, repetitive movements involving the shoulder, structures becoming inflamed and pressing on the nerve
69
Q

What is the nerve supply of the pectoralis major muscle

A

Medial and lateral pectoral nerves from the brachial plexus

70
Q

Attachments of the pectoralis major muscle

A
  • The clavicle (clavicular head)
  • The sternum and ribs (sternocostal head)
  • Intertubercular groove of the humerus
71
Q

Innervation of the pectoralis minor

A

Medial pectoral nerve

72
Q

Attachments of the pectoralis minor muscle

A
  • Anterior surface of ribs 3-5
  • coracoid process of scapula

–> imagine as a bridge that vessels passing into the upper limb must travel underneath

73
Q

Innervation of the trapezius muscle

A

Accessory spinal nerve - CN XI

74
Q

What is the action of the teres major on the shoulder joint

A

Adducts and medially rotates shoulder joint

75
Q

Action of the latissmus dorsi on the shoulder joint

A

Extends, adducts and medially rotates - raises body or arms during climbing

76
Q

Which muscles flex the shoulder joint

A
  • Anterior of deltoid
  • biceps brachi
  • pectoralis major
77
Q

Which muscles extend the shoulder joint

A
  • latissmus dorsi
  • teres major
  • long head of triceps
  • posterior fibres of deltoid
78
Q

Which muscles adduct the shoulder joint

A
  • Pectoralis major and minor
  • ## latissmus dorsi
79
Q

Contents of the axilla

A 
Axillary artery
Axillary vein 
Brachial plexus 
Auxiliary lymph nodes 
Coracorbrachialis and biceps brachi

MSK (12 decks)

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