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MSK Upper Limb Anatomy > Upper Limb 1 > Flashcards

Upper Limb 1 Flashcards

1
Q

What forms the anterior wall of the axilla

A

Pectorals Major and Minor

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2
Q

What forms the lateral wall of the axilla

A

Intertubecural Sulcus of the Humerus

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3
Q

What forms the posterior wall of the axilla

A

Subscapularis

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4
Q

What forms the medial wall of the axilla

A

Serratus Anterior + Thoracic wall

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5
Q

How would you describe the shape of the axilla?

A

Pyramidal (square based pyramid)

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6
Q

Explain the vasculature of the axilla and shoulder area using the following vessels ->brachial, brachiocephalic, axillary and subclavian arteries / cephalic, subclavian, internal jugular, superior vena cava and brachiocephalic veins.
Remember to note important landmarks and structures used to differentiate.

A

Brachiocephalic -> right subclavian (+right carotid)
Subclavian artery emerges between the anterior and middle scalene (where are the subclavian vein passes in front of the anterior scalene muscle) and passes along the top of the 1st rib.
As it reaches the lateral border of the 1st rib it becomes the axillary artery, traveling along the arm and shoulder until the level of the distal border of the teres major where it becomes the brachial artery.

The cephalic vein is found between the deltoid and pectoralis major muscles and joins with the subclavian vein prior to travelling under the pectoralis minor muscle. It also travels under the clavicle (and subclavicus muscle) and over the 1st rib but more medially than the artery. After passing anteriorly to the anterior scalene and meets the medial border of the 1st rib it joins with the internal jugular vein to form the brachiocephalic vein and this enters the thoracic cavity to join with the other one to form the SVC.

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7
Q

What nerve roots contribute to the upper trunk of the brachial plexus

A

C5 C6

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8
Q

What nerve roots contribute to the middle trunk of the brachial plexus

A

C7 only

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9
Q

What nerve roots contribute to the lower trunk of the brachial plexus

A

C8 + T1

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10
Q

What nerve roots form the brachial plexus

A

C5-8 + T1 ventral rami

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11
Q

Where do the nerve roots emerge? (Also along with which blood vessel)

A

Between anterior and middle scalene muscles along with the subclavian artery

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12
Q

After the trunk of the brachial plexus are formed describe what set of divisions happen next

A

Each trunk gives off a posterior branch to form the posterior cord
The upper trunk gives off an anterior branch to the lateral cord
The lower trunk gives off an anterior branch to the medial cord

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13
Q

What is the nerve roots of the musculocutaneous nerve according to the brachial plexus map?

A

Lateral cord, upper and middle trunk, C5-7

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14
Q

What is the actual nerve roots of the musculocutaneous nerves (ignoring the brachial plexus map)

A

C5-7 (matches)

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15
Q

What is the nerve roots of the axillary nerve according to the brachial plexus map?

A

Posterior cord, all three trunks, C5-8 + T1

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16
Q

What is the actual nerve roots of the axillary nerves (ignoring the brachial plexus map)

A

C5 + 6 (this is the biggest difference of the map)

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17
Q

What is the nerve roots of the median nerve according to the brachial plexus map?

A

Lateral and median cord, all three trunks, C5-8 + T1

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18
Q

What is the actual nerve roots of the median nerves (ignoring the brachial plexus map)

A

C6-8 + T1 (just slipping on the 5, but some individuals do sometimes have C5 branches)

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19
Q

What is the nerve roots of the Radial nerve according to the brachial plexus map?

A

Posterior cord, all three trunks so C5-8 + T1

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20
Q

What is the actual nerve roots of the Radial nerves (ignoring the brachial plexus map)

A

C5-8 + T1 (matches)

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21
Q

What is the nerve roots of the ulnar nerve according to the brachial plexus map?

A

Medial cord, lower trunk, C8 + T1

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22
Q

What is the actual nerve roots of the ulnar nerves (ignoring the brachial plexus map)

A

C8 + T1 (matches)

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23
Q

What is the difference in location between the radial and ulnar arteries?

A

Radial is lateral and ulnar is medial

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24
Q

What does the brachial artery turn into when it splits?

A

Radial and ulnar arteries

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25
Q

Explain the subcutaneous venous drainage of the forearm and hand

A

The dorsal venous arch is found in the dorsum of the hand. This gives off two veins - the cephalic (located medially) and the basilic (located laterally). These two veins communicate via the median cubital vein in the cubical fossa of the elbow.

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26
Q

What fingers does dermatome C5 innervate

A

False question -> it just innervates the should and upper area of the medial side

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27
Q

What area does dermatome C6 innervate?

A

Whole length of the lateral aspect of the arm (mainly posterior in the upper arm) and the thumb and lateral wrist

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28
Q

Describe dermatome C7

A

Innervates the whole middle section of the length of the posterior arm and the 2nd and 3rd fingers both anteriorly and posteriorly

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29
Q

C8 dermatome innervates what fingers and where else?

A

C8 innervates the last two fingers (4 and 5) and the medial aspect of the arm.

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30
Q

Does T1 dermatome touch the arm?

A

Yes, along with C5 it innervates the centre of the anterior aspect of the length of the forearm (under C5)

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31
Q

If there is an infection in the arm what lymph nodes will it travel to?

A

Axillary lymph nodes

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32
Q

If there is an infection in the medial aspect of the breast where will it go?

A

Internal thoracic lymph nodes

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33
Q

If there is an infection in the lateral aspects of the breast where will it go?

A

Axillary

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34
Q

If there is an infection in the scapula region where what lymph nodes is it likely to enlarge?

A

Axillary

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35
Q

If there is an infected tattoo around the umbilicus what lymph nodes is it likely to go to? (Also mention which sides)

A

Both sides axillary and superficial inguinal lymph nodes

36
Q

If there is an infection between the shoulder and umbilicus where is it likely to go?

A

Axillary or internal thoracic

37
Q

If there is an infection in the leg where is it likely to go?

A

(Superficial or deep) Inguinal lymph nodes

38
Q

If there is an infection in the head or neck region what lymph node is most likely to enlarge?

A

Cervical chain.

39
Q

Name the two clavicle joints

A

Acromioclavicular joint

Sternoclavicular Joint

40
Q

What type of joints form with the clavicle

A

Plane / Gliding Synovial Joints

41
Q

What part of the clavicle is most likely to fracture

A

Junction of the lateral third and medial two thirds

42
Q

Name the important process/landmark next to the acromial end of the clavicle

A

Conoid Tubercle

43
Q

Explain the scapulo-humeral rhythm

A

Beyond 30 degrees abduction of the arm from anatomical position (of which is done soley by the shoulder joint) the rest of the movement is in a 2:1 ratio between the shoulder (2 degrees movement) and scapulo-thoracic (1 degree movement) for every 3 degrees moved.
(Think when you raise your arm high you raise your chest)

44
Q

Name the 6 movements of the scapula

A 
Elevation 
Depression 
Protract
Retract
Lateral Rotation (elevating glenoid)
Medial Rotation (depressing glenoid)
45
Q

Name 2 muscles that elevate the scapula

A

Trapezius + Levator Scapulae

or rhomboids

46
Q

Name 2 muscles that depress the scapula

A

Serratus Anterior + Pectoralis Minor

or low fibres of the trapezius

47
Q

Name 2 muscles that protract the scapula

A

Serratus Anterior + Pectoralis Minor

48
Q

Name 2 muscles that retract the scapula

A

Trapezius + Rhomboids

49
Q

Name 2 muscles that laterally rotate the scapula (they elevate the glenoid cavity)

A

Trapezius + Serratus Anterior

50
Q

Name 2 muscles that medially rotate the scapula (they depress the glenoid cavity)

A

Levator Scapulae + Pectoralis Minor

gravity + rhomboids

51
Q

Name the structure associated to the glenoid cavity to enhance its shape and deepen its structure

A

glenoid labrum

52
Q

Name two main ligaments of the shoulder

A

Glenohumeral Ligaments
Coracohumeral Ligaments
Coracoacromial Ligaments
(Transverse Tubecular Ligament)

53
Q

Describe the glenohumeral ligament and function

A

Arises in the glenoid cavity and places on the anatomical neck of the humerus, running along with the fibrous capsule of the joint. Its function is to support the anterior part of the joint

54
Q

Describe the coraco-acromial ligament

A

Arises in the acromion and goes to the coracoid process. Function is to stop superior displacement of the humeral head

55
Q

Coracohumaral Ligament structure and function?

A

Arises in the coracoid process and attaches to the humeral greater tubercle. Main function of this is to provide anterior support to the joint

56
Q

What tendon holds the long tendon of the head of the bicep in place?

A

The transverse trabecular ligament

57
Q

What part of the shoulder is least protected by ligaments making it weak?

A

Posterior aspect

58
Q

Name two of the main bursae in the shoulder joint

A

Subacromial & Subscapular

59
Q

What is the function of a bursa

A

To reduce friction of a joint

60
Q

What can cause supraspinatous tendinitis?

A

Racket sports causing injury to the subacromial bursa

61
Q

What bursa can communicate with the shoulder joint capsule?

A

Sub scapular Bursa

62
Q

Name the 4 rotator cuff muscles

A

Subscapularis Muscle
Supraspinatous Muscle
Infraspinatous Muscle
Teres Minor

63
Q

What is the main function of the 4 rotator cuff muscles together?

A

Pulls the head of the humerus into the glenoid cavity to stabilise the joint

64
Q

What movement can the subscapularis muscle provide to the shoulder joint?

A

medial rotation

65
Q

What movement can the supraspinatous muscle provide to the shoulder joint

A

abduction (first 15 degrees)

66
Q

What movement can the infraspinatous muscle provide to the shoulder joint

A

Lateral rotation

67
Q

What muscle can the trees minor muscle provide to the shoulder joint

A

Lateral rotation

68
Q

What to bones does the rotator cuff muscles attach to

A

The scapula and the humerus

69
Q

Name two muscles that attach from the scapula to the humerus

A

Any of the rotator cuffs

Deltoid

70
Q

Describe the route of origin of the deltoid muscle

A

From the lateral spine of the scapula around the acromium to the first third of the clavicle

71
Q

Describe the movements the deltoid permits

A

Flexion -> anterior fibres
Abduction -> middle fibres
Extension -> posterior fibres

72
Q

What is the innervation of the deltoid?

A

Axillary nerve

73
Q

What is the most common injury to the axillary nerve?

A

Fracture of the humeral anatomical neck

74
Q

What signs/symptoms should you test for in this situation?

A

Loss of sensation in the inferior region of the deltoid otherwise known as the regimental badge area

75
Q

Where does the pectoralis major muscle originate and join to?

A

Arises from medial third of clavicle and sternal edge and attaches to the anterior ridge of the humeral tuberosity

76
Q

What movements can the pectoralis major muscle permit (2)

A

Adduction

Medial Rotation

77
Q

What is the name of the triangle located between the deltoid and pec major

A

Deltopectoral triangle

78
Q

What is located in the deltopectorial triangle and its clinical significance

A

Cephalic vein used for central lines

79
Q

What is the innervation of the serratus anterior?

A

long thoracic nerve

80
Q

What is the function of the serratus anterior?

A

Protracts and stabilises the scapula

81
Q

What procedure can damage the long thoracic nerve?

A

Manipulation of the glenohumeral joint

82
Q

What will happen if the long thoracic nerve is damaged

A

Winged scapula due to paralysis of the serratus anterior

83
Q

Describe the lay out of the trapezius muscle and explain why this gives it three different movement functions

A

Wide span muscle with fibres above, inline and below the scapular allowing to the elevate, retract and depress the scapula.

84
Q

What nerve innervates the scapula

A

Accessory (cranial nerve XI)

85
Q

What is the action of the teres major

A

Adducts and medially rotates the arm

86
Q

What is the action latissimus dorsi on the shoulder joint

A

Extend, adduct and medially rotate

MSK Upper Limb Anatomy (1 decks)

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