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MSK Anatomy > Upper Limb 1 > Flashcards

Upper Limb 1 Flashcards

1
Q

What forms the anterior, posterior, medial and lateral walls of the axilla?

A

Anterior:
-Pectoralis Major and minor

Posterior wall
-Teres Major and Latissimus dorsi

Medial wall
-Thoracic wall and serratus anterior

Lateral wall
-Intratubercular sulcus of the humerus

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2
Q

The axillary artery is the continuation of which artery?

A

Subclavian artery

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3
Q

At what anatomical point does the subclavian artery become the axillary artery?

A

Lateral border of the 1st rib

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4
Q

The axillary artery continues beyond the axilla as which vessel?

A

Brachial artery

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5
Q

At what anatomical point does the axillary artery become the brachial artery?

A

Inferior border of the teres major

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6
Q

When may compression of the axillary artery be necessary?

A

Profuse bleeding occurs due to severe injury to the upper limb

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7
Q

What spinal nerve roots form the brachial plexus?

A 
C5
C6
C7
C8
T1
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8
Q

Which nerve roots form the upper trunk, middle trunk and lower trunk of the brachial plexus?

A

Upper
-C5 and C6

Middle
-C7

Lower
-C8 and T1

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9
Q

What is Erb’s point and what is the clinical relevance of it?

A

Point of unison of C5 and C6 forming the upper trunk of the brachial plexus.

Injury commonly sustained at this point during birth or from a fall onto the shoulder.

Causes Erb’s palsy resulting in characteristic waiter’s tip appearance of the upper limb -> medialy rotated with wrist flexed

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10
Q

What muscles are effected by Erb’s palsy?

What nerves supply them?

A

Musculocutaneous nerve:

  • Biceps brachii
  • Brachialis
  • Coracobrachialis

Radial nerve
-Brachioradialis

Axillary nerve
-Deltoid

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11
Q

Injury to the lower trunk of the brachial plexus causes what?

(what is the cause of this injury, what is effected, what is it called)

A

Klumpke’s palsy

Muscles effected:

  • Intrinsic muscles of the hand
  • Ulnar flexors of the wrist and fingers

Cause of injury is undue abduction of the arm
-Trying to grab a branch while falling

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12
Q

What forms the medial, posterior and lateral cords of the brachial plexus?

A

Lateral cord
-Upper trunk and middle trunk

Posterior cord
-Upper, middle and lower trunks

Medial cord
-lower trunk

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13
Q

Musculocutaneous nerve comes from which brachial plexus cord?

A

Lateral cord once the branch for the median nerve is given off

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14
Q

What cords form the median nerve?

A

Lateral and medial cords give off fibres forming the median nerve

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15
Q

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

A

Axillary and radial nerve
Thoracodorsal nerve
Upper and lower subscapular nerve

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16
Q

What cord does the ulnar nerve come from?

A

Medial cord once fibres are given off for the median nerve

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17
Q

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

A

Lateral pectoral
Lateral root of median nerve
Musculocutaneous nerve

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18
Q

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

A 
Medial pectoral
Ulnar nerve
Medial root of median nerve
Medial cutaneous nerve of the arm
Medial cutaneous nerve of the forearm
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19
Q

What two veins arise at the dorsal venous arch and where on this arch?

A

Cephalic vein at lateral end

Basilic vein at medial end

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20
Q

The median cubital vein is a large communicating vein which shunts blood from where to where?

A

cephalic vein -> basilic vein

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21
Q

Where do lymphatic vessels from the upper limb drain?

A

Axillary nodes

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22
Q

Name the 5 distinct groups of axillary lymph nodes

A 
Anterior or pectoral group
Posterior or subscapular group
Apical group
Central group
Lateral group
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23
Q

Infection in the little finger will drain to lymph nodes where?

A

Axilla

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24
Q

A boil in the scapular region will drain to lymph nodes where?

A

Axilla

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25
Q

The medial and lateral portions of the breast drain lymph where?

A

Medial -> internal thoracic

Lateral -> axilla

26
Q

Infection around the umbilicus (e.g. infected tattoo) would drain lymph where?

A

Above umbilicus -> axilla

Below umbilicus -> superficial inguinal

27
Q

The entire upper limb and pectoral girdle articulate at one small joint only, which is this?

A

Sternoclavicular

28
Q

Which part of the clavicle is weakest and commonly breaks?

A

Junction of middle and lateral thirds

29
Q

What type of synovial joint are the acromioclavicular (AC) and sternoclavicular (SC) joints?

A

Acromioclavicular -> plane

Sternoclavicular -> saddle

30
Q

What is the scapulohumeral rhythm?

A

Consider abduction of the arm from the anatomical position.

Initially, all movement will be at the glenohumeral joint, but beyond about the first 30 degrees, for every 3 degrees of abduction, 2 degrees occurs at the shoulder joint and 1 degree at the scapulothoracic joint (2:1 ratio)

31
Q

What muscles cause elevation of the scapula?

A

levator scapulae
Upper trapezius
Rhomboids

32
Q

What muscles cause depression of the scapula?

A

Lower trapezius

Pectoralis major and minor

33
Q

What muscles cause protraction of the scapula?

A

Serratus anterior

Pectoralis major and minor

34
Q

What muscles cause retraction of the scapula?

A

Middle trapezius

Rhomboids

35
Q

What muscles cause rotation depressing the glenoid cavity?

A

Inferior trapezius

Inferior part of serratus anterior

36
Q

What is the glenoid labrum?

A

Rim of cartilage surrounding the socket of the glenoid cavity.

Doubles the glenoid depth and increases the surface area.
Acts as a “chock block” limiting glenohumeral translation

37
Q

The coracohumeral ligament strengthens what aspect of the joint capsule

A

superior aspect

38
Q

The coracoacromial arch is made up of what 3 structures?

A

Acromion
Coracoid process of the scapula
Coraco-acromial ligament

39
Q

Which bursa communicates with the shoulder joint cavity?

A

Subscapula bursa

40
Q

What is the role of the subacromial bursa?

A

Facilitates movement of the supraspinatus tendon under the coraco-acromial arch and of the deltoid over the joint capsule and the greater tubercle of the humerus

41
Q

What movements of the glenohumeral joint are generated by the rotator cuff muscles?

A

Abduction, lateral and medial rotation

42
Q

Where does the origin of the deltoid extend from?

A

Lateral spine of the scapula, across the acromion to the lateral 3rd of the clavicle

43
Q

What do each of the fibres of the deltoid do?

A

Anterior fibres -> medially rotate and flexes at the shoulder joint

Middle fibres -> abduct at the shoulder joint

Posterior fibres -> extend and laterally rotate at the shoulder joint

44
Q

What is the nerve supply to the deltoid?

A

Axillary nerve

45
Q

Where could you test for loss of sensation in axillary nerve injury?

A

Shoulder badge region
Lateral side of proximal part of arm - C5 dermatome

Superior lateral cutaneous nerve of the arm

46
Q

Where do the fibres of the pectoralis major originate?

A

Medial third of the clavicle, the sternum and ribs

47
Q

What is the action of the pectoralis major on the shoulder joint?

A

Adduct and medially rotate the humerus at the glenohumeral joint

48
Q

What is the deltopectoral triangle?

Why is it important?

A

Triangular space below the clavicle, between deltoid and pactoralis major muscle.

Subclavian vein is vound in this triangle for the insertion of central lines

49
Q

What is the funtcion of the serratus anterior?

A

Protraction of the scapulae, but mainly serves to stabilise it during limb movements and to keep it pulled against the thoracic cage

50
Q

What is the nerve supply to serratus anterior?

A

Long thoracic nerve

51
Q

What clinical sign do you see when the long thoracic nerve is injured?

A

Winged scapula

52
Q

What do all the different fibres of the trapezius do to the scapula?

A

Superior fibres -> elevate
Middle fibres -> retract
Inferior fibres -> depress

53
Q

What is the nerve supply to the trapezius?

A

Accessory nerve

54
Q

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

A

Adducts and medially rotates

55
Q

What is the action of latissimus dorsi on the shoulder joint?

A

Extends, adducts and medially rotates shoulder joint

56
Q

What muscles flex the shoulder?

A

Biceps bracii
Pectoralis major
Anterior deltoid
Coracobrachialis

57
Q

What muscles extend the shoulder?

A

Posterior deltoid
Latissimus dorsi
Teres major

58
Q

What muscles adduct the shoulder?

A

Pectoralis major
Latissimus dorsi
Teres major

59
Q

What muscles abduct the shoulder?

A

Middle part of deltoid
Supraspinatus
Trapezius
Serratus anterior

60
Q

What msucles cause medial or internal rotation of the shoulder?

A

Subscapularis
Lattisimus dorsi
Pectoralis major
Teres major

61
Q

What muscles cause lateral or external rotation?

A

Teres minor and infraspinatus

MSK Anatomy (14 decks)

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