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Year 3 - Musculoskeletal > Upper limb 1 > Flashcards

Upper limb 1 Flashcards

1
Q

Anterior wall
Posterior wall
Medial wall
Lateral wall

of axilla made up of what

A

Anterior wall - pec major and minor
Posterior wall - subscapularis
Medial wall - thoracic wall + serratus anterior
Lateral wall - intertubercular sulcus of humerus

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2
Q

Apex (axillary inlet) of axilla located at

A

Lateral border of 1st rib

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3
Q

Contents of axilla

A 
Axillary artery 
Axillary vein
Brachial plexus
Axillary lymph nodes
Tendons of short head of biceps brachii & coracobrachialis
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4
Q

Axillary artery is a continuation of what artery + what does axillary continue as

A

Subclavian

Brachial

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5
Q

What point does the subclavian become the axillary artery

A

Lateral border of 1st rib

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6
Q

What point does the axillary become the brachial artery

A

Inferior border of teres major

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7
Q

Brachial plexus is the ventral rami of

A

C5-T1

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8
Q

Brachial plexus:

5 roots –> 3 … –> 6 … –> 3 … –> 5 …

A

3 trunks - superior, middle, inferior

6 divisions - each trunk divides into anterior + posterior division

3 cords - different divisions combine to form lateral, posterior + medial cord (see other flashcard)

5 major branches - given off by the 3 cords

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9
Q

What nerve roots of the brachial plexus form the

  • superior trunk
  • middle trunk
  • inferior trunk
A

Superior - C5 + C6
Middle - C7
Inferior - C8 + T1

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10
Q

What is erb’s point

A

Auscultation point for heart sounds + murmurs at the left sternal border 3rd intercostal space

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11
Q

What is erb’s palsy + what is the characteristic clinical sign

A

Injury to upper trunk (C5-6) of brachial plexus –> characteristic ‘waiter’s tip’ sign where

  • shoulder is internally rotated
  • elbow extended + pronated
  • wrist flexed
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12
Q

Causes of erb’s palsy

A

Usually due to large size or shoulder dystocia (shoulders too wide) in neonates so too big to fit through birth canal

In adults - high impact injuries

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13
Q

What group of muscles are affected in erb’s palsy if it is the upper trunk of brachial plexus that is affected

A

C5 - elbow flexors (brachialis, biceps brachii, corachoradialis + brachioradialis)

C6 - wrist extensors (extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor digitorum (ED), extensor digiti minimi (EDM), extensor carpi ulnaris (ECU), abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL), and extensor indicis (EI))

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14
Q

What is klumpke’s palsy (RARE)

A

Injury to the inferior trunk of the brachial plexus

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15
Q

What group of muscles are affected in klumpke’s palsy if it is the inferior trunk of brachial plexus that is affected

A

Intrinsic muscles of hand

Ulnar flexors of wrist + fingers

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16
Q

The cords (lateral/posterior/medial) of the brachial artery are named in relation to what structure

A

Axillary artery in the axilla

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17
Q

In the axilla and the proximal aspect of the upper limb, the three cords give rise to five major nerve branches - name these

A 
Musculocutaneous
Axillary
Median
Radial
Ulnar
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18
Q

The lateral cord of the brachial plexus is formed by the combination of which divisions (2)

A

The anterior division of the superior trunk

The anterior division of the middle trunk

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19
Q

The posterior cord of the brachial plexus is formed by the combination of which divisions (3)

A

The posterior division of the superior trunk
The posterior division of the middle trunk
The posterior division of the inferior trunk

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20
Q

The medial cord of the brachial plexus is formed by which division

A

The anterior division of the inferior trunk

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21
Q

Main branches of

  • lateral cord
  • posterior cord
  • medial cord
A

Lateral - musculocutaneous nerve, lateral root of median nerve
Posterior - axillary nerve, radial nerve
Medial - ulnar nerve, medial root of median nerve

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22
Q

Superficial veins of the upper limb

A

Dorsal venous arch
Cephalic vein
Basilic vein
Median cubital vein

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23
Q

What vein joins the cephalic and basilic vein + this vein shunts blood from cephalic to basilic or basilic to cephalic

A

Median cubital - shunts blood from cephalic to basilic

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24
Q

Dermatomes of upper limb

  • regimental badge patch area
  • thumb
  • middle finger
  • pinky
  • axilla
A 
C5
C6
C7
C8
T1
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25
Q

All lymphatics in the upper limb drain into which group of lymph nodes

A

Axillary

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26
Q

What 2 bones make up the pectoral girdle, connecting the upper limb to the axial skeleton

A

Scapula and clavicle

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27
Q

The upper limb and pectoral girdle articulate with the axial skeleton at one small joint - name this

A

Sternoclavicular

28
Q

Clavicle has 2 ends - name them

A

Acromial end and sternal end

29
Q

The conoid tubercle on the clavicle is the attachment point for what

A

Conoid ligament - which binds clavicle to coracoid process of scapula

30
Q

Which part of the clavicle is the weakest

A

Junction between anterior 2/3 and outer 1/3, essentially the MIDDLE SHAFT (because thinnest)

31
Q

What type of joint is the acromioclavicular joint

A

Synovial plane

32
Q

What type of joint is the sternoclavicular joint

A

Synovial saddle

33
Q

Abduction of the arm from the anatomical position occurs at the glenohumeral (shoulder) joint for the first 30 degrees but beyond that, for every 3 degrees of abduction, 2 degrees occurs at … joint and 1 degree at the … joint

A

2 degrees at the glenohumeral joint

1 degree at the scapulothoracic joint

34
Q

What is the scapulothoracic joint

A

Not a true anatomical joint

It is just the movement on the scapula on the posterior thoracic wall

35
Q

Name the 6 movements that occur at the scapula

A 
Elevation
Depression
Protraction
Retraction
Lateral rotation
Medial rotation
36
Q

Name the muscles that
-elevate (2)
-depress (3)
the scapula

A

Elevate - upper fibres of trapezius, levator scapulae

Depress - pec major, lower fibres of trapezius, lattisimus dorsi, (gravity)

37
Q

Name the muscles that
-protract (2)
-retract (3)
the scapula

A

Protract - serratus anterior (MAINLY), pec minor

Retract - middle fibres of trapezius, rhomboid major + minor

38
Q

Name the muscles that
-laterally (upward) rotate (2)
-medially (downward) rotate (3)
the scapula

A

Laterally rotate - trapezius, serratus anterior

Medially rotate - levator scapulae, rhomboid major + minor

39
Q

What are the 2 articular surfaces of the glenohumeral joint

A

Glenoid cavity of the scapula
+
Head of the humerus

40
Q

What type of joint is the glenohumeral joint

A

Ball + socket

41
Q

The rim of cartilage surrounding the glenoid cavity of the scapula is known as the

+ functions of this (2)

A

Glenoid labrum

Function - deepens the glenoid cavity, shock absorption

42
Q

Name the ligaments associated with the glenohumeral joint

A

Coracohumeral
Coracoclavicular
Glenohumeral
Transverse humeral

43
Q

Coracohumeral ligament strengthens which aspect of the joint capsule

A

Anterior

44
Q

The coraco-acromial arch is made up of what 3 things

+ function

A

Acromion
Coracoid process
Coraco-acromial ligament

Prevents superior displacement of the humeral head from the glenoid cavity

45
Q

Which part of the glenohumeral joint is the weakest

A

Inferior part because it’s not protected by muscles or ligaments

46
Q

What are the 2 main bursa of the shoulder joint

+ which of these communicates with the joint cavity

A

Subacromial bursa

Subscapular bursa - communicates with joint cavity

47
Q

Function of the subacromial bursa

A

Decreases friction beneath the deltoid and allows smooth motion of the rotator cuff tendons

48
Q

Common cause of subacromial bursitis

A

Repeated minor trauma such as repetitive overhead motions, e.g. swimming

49
Q

Name the 4 rotator cuff muscles

A

Subscapularis
Supraspinatus
Infraspinatus
Teres minor

50
Q

Function of the rotator cuff muscles collectively

A

Resting tone of these muscles act to compress the humeral head into the glenoid cavity, so stabilising the GH joint

51
Q

Function of deltoid

  • anterior fibres
  • middle fibres
  • posterior fibres
A

Anterior fibres - flex + medially rotate arm at GH joint

Middle fibres - abduct arm at GH joint (MAJOR ABDUCTOR OF ARM)

Posterior fibres - extend + laterally rotate arm at GH joint

52
Q

Innervation of deltoid

A

Axillary nerve

53
Q

Clinical sign seen when long thoracic nerve damaged

A

Winged scapula

-as long thoracic nerve innervates serrates anterior which holds scapula against ribs

54
Q

Functions of trapezius

  • superior fibres
  • middle fibres
  • inferior fibres
A

Superior - elevate scapula
Middle - retract scapula
Inferior - depress scapula

55
Q

Innervation of trapezius

A

CN XI

56
Q

Actions of teres major (2)

A

Adduct + medially rotate arm at GH joint

57
Q

Actions of latissimus dorsi on GH joint (3)

A

Extend
Adduct
Medially rotate

58
Q

Muscles that flex GH joint (4)

A

Pec major
Anterior fibres of deltoid
Corachobrachialis
Biceps brachii (WEAKLY ASSISTS)

59
Q

Muscles that extend GH joint (2)

A

Posterior fibres of deltoid
Latissimus dorsi

(Teres major)
(Teres minor)

60
Q

Muscles that abduct at GH joint (4)

A

Supraspinatus - first 15 degrees
Middles fibres of deltoid - next 15-90 degrees
Trapezius + serratus anterior - past 90 degrees

61
Q

Muscles that adduct at GH joint (3)

A

Pec major
Latissimus dorsi
Teres major

62
Q

Muscles that internally/medially rotate at GH joint (5)

A 
Subscapularis
Pectoralis major
Latissimus dorsi
Teres major
Anterior fibres of deltoid
63
Q

Muscles that externally/laterally rotate at GH joint (2)

A

Infraspinatus

Teres minor

64
Q

Actions of teres major (2)

A

Medial rotation + adduction of arm at GH

65
Q

Function of coraco-acromial ligament

A

Prevent superior displacement of humeral head

Year 3 - Musculoskeletal (26 decks)

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