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MSK Anatomy > Upper Limb 1 > Flashcards

Upper Limb 1 Flashcards

1
Q

what is the anterior wall of the axilla formed by?

A

pectoralis major and minor muscle, subclavius muscle

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2
Q

what is the posterior wall of the axilla formed by?

A

subscapularis muscle, teres major and latissimus dorsi

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3
Q

what is the medial wall of the axilla formed by?

A

thoracic wall and serratus anterior muscle

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4
Q

what is the lateral wall of the axilla formed by?

A

the intertubercular sulcus/groove of humerus

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5
Q

structures of axilla? (6)

A
  1. axillary a and branches
  2. axillary veins and tributaries
  3. brachial plexus
  4. Axillary lymph nodes and vessels
  5. Biceps brachii muscles
  6. Coracobrachialis muscle
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6
Q

The axillary a is continuation of which artery

A

subclavian

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7
Q

at what anatomical point does axillary a begin?

A

lateral border of 1st rib

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8
Q

the axillary a continues beyond the axilla as which vessel?

A

the brachial a

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9
Q

at what anatomical point does the name of this vessel change?

A

inferior border of teres major

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10
Q

What nerve roots form the upper trunk?

A

C5 and C6

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11
Q

what is Erb’s point and what is its clinical relevance?

A

The point where C5 and C6 converge to form the upper trunk. Erb’s point is the auscultation location for heart sounds and heart murmurs located at the third intercostal space and the left lower sternal border.

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12
Q

which group of muscles are affected in Erb’s palsy?

A

muscles supplied by C5-C6. So paralysis occurs of biceps brachii, brachialis, coracobrachialis and brachioradialis

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13
Q

which is more medial, long or short head of biceps brachii?

A

short

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14
Q

what is the attachment of the coracobrachialis muscle

A

coracoid process of scapula

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15
Q

acronym to remember order of brachial plexus stages

A

Read That Damn Card Back

Roots, Trunks, Divisions, Cords, (terminal) Branches

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16
Q

which segmental roots of the brachial plexus contribute to the lower trunk?

A

C8 and T1

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17
Q

What does injury to the lower trunk cause? which muscles are affected?
what is the cause of injury?

A

Klumpke’s palsy. the intrinsic muscles of hand and ulnar flexors of the wrist and fingers.
cause of injury - undue abduction of the arm

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18
Q

what is the cause of injury in Klumpke’s palsy?

A

undue abduction of the arm

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19
Q

the cords in the brachial plexus are named for their position in relation to what?

A

axillary artery in the axilla

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20
Q

major branches of brachial plexus, in order from most lateral to medial

A 
musculocutaneous
axillary
radial
medial
ulnar nerve
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21
Q

branches of the lateral cord of brachial plexus

A

musculocutaneous nerve
lateral pectoral nerve
lateral root of median nerve

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22
Q

branches of the medial cord of brachial plexus

A 
ulnar nerve
medial pectoral nerve
medial root of median nerve
medial cutaneous nerve of arm
medial cutaneous nerve of forearm
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23
Q

branches of the posterior cord of brachial plexus

A

axillary nerve
radial nerve
thoracodorsal nerve
subscapular nerve

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24
Q

which cord does the radial nerve come off of?

A

posterior

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25
Q

which cord does the axillary nerve come off of?

A

posterior

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26
Q

which cord does the musculocutaneous nerve come off of?

A

lateral cord

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27
Q

which cord does the median nerve come off of?

A

both the lateral and medial cords

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28
Q

which cord does the ulnar nerve come off of?

A

medial cord

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29
Q

what nerves supply anterior arm and which supply posterior arm

A

anterior - musculoskeletal and ulnar

posterior - radial

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30
Q

major arterial branches of upper limb

A

subclavian, axillary, brachial, radial, ulnar, deep palmar arch

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31
Q

venous drainage of upper limb

A

axillary vein, cephalic vein, basilic vein, median cubital vein, dorsal venous network

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32
Q

why are superficial veins of the upper limb important?

A

commonly used for intravenous injections for transfusion and for withdrawing blood for testing

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33
Q

which one is lateral and which one is medial to the dorsal venous arch? (basilic and cephalic veins)

A

basilic lateral

cephalic medial

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34
Q

what does the median cubital vein do

A

shunts blood from basilic vein to cephalic vein

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35
Q

all lymphatic vessels from upper limb drain into..

A

axillary lymph nodes

36
Q

5 groups of the axillary lymph nodes?

A
  1. anterior or pectoral group
  2. posterior or subscapular group
  3. apical group
  4. central group
  5. lateral group
37
Q

which group of lymph nodes will involved in infection of little finger

A

axillary LN

38
Q

which group of lymph nodes will involved in boil of the scapular region

A

axillary LN

39
Q

which group of lymph nodes will involved in medial part of breast (close to sternum)

A

internal thoracic (internal mammary) LN

40
Q

which group of lymph nodes will involved in lateral part of breast (close to axilla)

A

axillary LN

41
Q

which group of lymph nodes will involved in infection around the umbilicus?

A

both axillary and superficial inguinal groups. the umbilicus is the boundary for which lymph nodes above drain into axillary ln and below drain into superficial inguinal ln

42
Q

what is the pectoral girdle?

A

set of bones that connect the upper limb to the axial skeleton on each side

43
Q

the entire upper limb and pectoral girdle articulate at which joint?

A

sternoclavicular joint

44
Q

what is the only joint in the upper limb that directly articulates with the trunk?

A

sternoclavicular joint

45
Q

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

A

junction of medial 2/3 and lateral 1/3 OR junction of convex medial 2/3 and concave lateral 1/3

46
Q

what type of synovial joints are the acromioclavicular and sternoclavicular joint, and glenohumeral joint?

A

AC - synovial plane
SC - synovial saddle joint
GH - synovial ball and socket

47
Q

what is the scapulo-humeral rhythm?

A

when abducting the arm the first 30 degrees all movement is at shoulder (GH) joint, but beyond that for every 3 degrees, 2 degrees occurs at shoulder joint and 1 degree at scapula-thoracic joint

48
Q

which muscles carry out elevation of scapula?

A
  1. superior fibres of trapezius muscle
  2. levator scapulae
  3. rhomboids
49
Q

which muscles carry out depression of scapula?

A
  1. inferior fibres of trapezius muscle
  2. pectoralis minor
  3. subclavius muscle
  4. serratus anterior
  5. latissimus dorsi
50
Q

which muscles carry out protraction (Forward movement) of scapula?

A
  1. serratus anterior
  2. pectoralis major
  3. pectoralis minor
51
Q

which muscles carry out retraction (backward movement) of scapula?

A

middle fibres of trapezius, rhomboids

52
Q

which muscles carry out lateral (upward) rotation of scapula?

A

superior fibres of trapezius

serratus anterior

53
Q

which muscles carry out medial (downward) rotation of scapula?

A

levator scapulae, rhomboids, pectoralis minor

54
Q

what is the name of the cartilage that surrounds the glenohumeral joint? what is its function?

A

the glenoid labrum.
this elevates the glenoid edge, doubling the glenoid depth and increasing its surface area. this results in the ball (head of humerus) staying in place.

55
Q

what does the coracohumeral ligament do?

A

strengthen the superior aspect of the joint capsule

56
Q

what is the coraco-acromial arch made up of? what does it do?

A

the acromion and coracoid process of scapula and coracoacromial ligament.
function: it prevents superior displacement of the humeral head.

57
Q

which part of the shoulder joint capsule is weakest, and not protected by muscles or ligaments?

A

the infraglenoid tubercle. its just anterior to the attachment of the long head of the triceps.

58
Q

what do bursae do and which bursa communicates with the joint cavity?

A 
they cusion the joints via their fluid.
subacromial bursa (also called subdeltoid)
59
Q

what is the role of the subacromial bursa?

A

to support the deltoid and suprapsinatus muscles

60
Q

what common sporting injury damages the subacromial bursa?

A 
subacromial bursitis (A type of rotator cuff injury)
dislocation
61
Q

name the 4 rotator cuff muscles

A

subscapularis, supraspinatus, infraspinatus, teres minor

62
Q

what movements to the rotator cuff muscles carry out?

A

abduction, adduction, medial and lateral rotation

63
Q

what are the roles of the rotator cuff muscles?

A

to move the glenohumeral joint

to stabilise the glenohumeral joint and keep the head of humerus in the glenoid cavity

64
Q

what do the anterior, middle and posterior fibres of deltoid do?

A

anterior - flexion and medial rotation at shoulder joint
middle - abduction at shoulder joint
posterior - extension and external rotation at shoulder joint

65
Q

what is the nerve supply to deltoid?

A

axillary nerve

66
Q

in what common injury is the axillary nerve often trapped and damaged?

A

a surgical neck of the humerus fracture

67
Q

where would you test to see if there has been damage to axillary nerve?

A

badge patch area

68
Q

where do the fibres of the pectoralis major muscle originate from?

A

medial third of clavicle, sternum and ribs

69
Q

whats the action of the pec major?

A

flex and medially rotate the humerus at the glenohumeral joint

70
Q

what is the triangular space below the clavicle, between deltoid and pec major? what is found in this triangle?

A

deltopectoral triangle.

cephalic vein is found here

71
Q

what does serratus anterior do?

A

protraction of scapulae

72
Q

nerve supply to serratus anterior?

A

long thoracic nerve (Nerve of Bell)

73
Q

what clinical sign is seen when the long thoracic nerve (nerve of bell) is injured?

A

scapular winging

74
Q

what are the symptoms of scapular winging

A
  1. cant raise arm above shoulder
  2. pain in neck, back and shoulder
  3. fatigue
  4. drooping shoulder
75
Q

during which procedure is the long thoracic nerve (nerve of bell) commonly injured?

A

surgery for breast cancer - radical mastectomies that involve removal of axillary LN.

76
Q

what are the 3 fibres of the trapezius? functions?

A

superior fibres of trapezius - elevate scapula
middle fibres - retraction of scapula
inferior fibres - depression of scapula

77
Q

innervation of trapezius?

A

accessory nerve (cranial nerve XI)

78
Q

what are the actions of teres major on the shoulder joint?

A

adducts and medially rotates arm at the shoulder joint.

79
Q

what are the actions of latissimus dorsi on shoulder joint?

A

extends, adducts and medially rotates humerus at shoulder joint.
raises body towards arms during climbing.

80
Q

what muscles carry out flexion of shoulder joint?

A

both heads of biceps brachii
pec major
anterior deltoid
corachobrachialis

81
Q

what muscles carry out extension of shoulder joint?

A

posterior deltoid
latissimus dorsi
teres major

82
Q

what muscles carry out adduction of shoulder joint?

A

pec major
latissimus dorsi
teres major

83
Q

what muscles carry out abduction of shoulder joint?

A

supraspinatus (0-15 degrees)
middle part of deltoid (15 - 90 degrees)
for abduction more than 90 degrees, need scapula to rotate, done by trapezius and serratus anterior

84
Q

what muscles carry out medial or internal rotation of shoulder joint?

A 
subscapularis
lattisimus dorsi
pectoralis major
teres major
anterior deltoid
85
Q

what muscles carry out lateral or external rotation of shoulder joint?

A

teres minor and infraspinatus

MSK Anatomy (7 decks)

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