Upper limb Flashcards
What are the borders of the axilla (anterior, posterior, medial, lateral)?
Anterior - pectorals major, pectorals minor.
Posterior - teres major, scapulars, latissimus dorsi.
Medial - serrates anterior.
Lateral - inter tubercular sulcus of the humerus.
What are the points of change for subclavian artery - axillary artery - brachial artery - radial + ulnar artery?
- Subclavian becomes axillary at the lateral border of rib 1.
- Axillary artery becomes brachial at the inferior border of theres major.
- the brachial artery becomes radial and ulnar at the cubital fossa.
Which muscles does the brachial plexus emerge from?
The anterior scalene and middle scalene muscles.
What is Erb’s Palsy?
This is caused by injury to the superior trunk - C5 and C6.
It causes medial rotation of the arm and flexion of the wrist.
Usually caused by hyper-extension of the neck.
What is Klumpe’s Palsy?
This is caused by an injury to the inferior trunk - C8 and T1.
It causes paralysis of the intrinsic hand muscles, the flexors of the wrist and fingers.
What is the root value of the ulnar nerve?
C8, T1.
what is the root value of the median nerve?
C5, C6, C7, C8, T1.
What is the root value of the radial nerve?
C5, C6, C7, C8, T1.
What is the root value of the musculocutaneous nerve?
C5, C6, C7.
What is the root value of the axillary nerve?
C5, C6.
What is the venous drainage of the upper arm?
The basilica vein (medial side), the cephalic vein (lateral side), the median cubital vein. theres also ulnar, radial and brachial veins but these are much deeper and run beside the arteries.
Which vein does the cephalic vein drain into?
The axillary vein.
What does the basilica vein become and at what level?
It becomes the axillary vein a the lower border of theres minor.
What muscle does the musculocutaneous nerve pierce?
The coracobrachialis.
What is the dermatomes of the anterior side of the arm?
C5 - T1.
What are the dermatomes on the posterior side of the arm?
Only C6, C7, C8.
What type of injury would cause a dermatomal sensory loss?
A spinal root lesion.
What is the main lymphatic vessel of the upper limb?
The axillary nodes. the apical group is the final common pathway.
THa axillary lymph nodes are affected in cancers above the umbilicus and wall of thorax, breast, arm.
What is the name of the shoulder joint?
the glenohumeral joint.
What is the weakest part of the clavicle?
the middle 1/3rd segment.
What are the 4 main ligaments in the shoulder?
The coracoclavicular ligament (made of 2 ligaments)
the acromioclavicular ligament
the coracoacromio ligament.
Coracohumeral ligament
what are the joints involved in abduction of the arm?
the 1st 30 degrees is done by the shoulder joint. after this its done by the scapula.
for every 3 degrees after 30 degrees, 2 degrees occur at the glenohumeral joint, 1 degree occurs at the scapula thoracic joint.
What part of the shoulder is the weakest?
the inferior/anterior region.
What are the 2 main bursae of the shoulder?
Subacromial bursa and subscapular bursa.
What are the 4 rotator cuff muscles?
- subscapularis.
- supraspinatus
- Infraspinatus
- Teres minor
What is the main function of the orator cuff muscles?
to stabilise the glenohumeral joint. all 4 muscles arise from the scapula and insert into the humerus.
What is the function of the deltoid muscle?
anterior fibres - flex and medially rotate
middle fibres - abduct the arm
posterior fibres - extend and laterally rotate the arm.
What nerve is damaged causing winged scapula?
Long thoracic nerve - serrates anterior is paralysed.
How is abduction of the arm carried out?
1st 15 degrees - supraspinatus muscle.
up to 90 degrees - deltoid muscle.
90-180 - serratus anterior and trapezius
What nerve enervates the anterior muscles of the arm?
Musculocutaneous nerve
What are the 3 muscles of the anterior arm?
Biceps bracii, coracobraciallis, brachialis.
What are the 3 muscles that attach to the medial border of the scapula?
Rhomboid major, rhomboid minor and levator scapulae.
What type of joint is the sternoclavicular joint?
A synovial saddle joint
WHat type of joint is the acromioclavicular joint
A synocial plane joint.
What does the trapezius muscle do?
superior/descending fibres - elevate the scapula
middle fibres - retracts the scapula
ascending/inferior fibre s- depress the scapula.
what is the main protractor of the scapula?
The serratus anterior - innervated by the long thoracic nerve.
Which rotator cuff msucles insert onto the greater tubercle?
Supraspinatous, infraspinatous and the teres minor.
SIT - from anterior to posterior. (with the subscapularis in front).
Which rotator cuff muscle inserts onto the lesser tubercle?
Subscapularis - involved in medial rotation of the arm.
Where does the trees major insert?
The medial lip of the intertubercular groove.
What is the innervation of the deltoid and teres minor muscles?
Axillary nerve
What is the action of the pectorals major?
To adduction, flexion and medial rotation of arm
What is the action of the pectorals minor muscle?
To stabilise the scapula by pulling it against the thoracic cage.
What is the role of the serratus anterior?
To protract the scapula.
What is the action of latissimus dorsi?
internal rotation, adduction and extension of the arm.
What is the main action of the brachialis muscle?
Strong flexion of the elbow.
Which nerve supplies all of the muscles in the anterior compartment of the arm?
The musculocutaneous nerve
What part of skin does the musculocutaneous nerve supply?
the lateral part of the forearm - as the lateral cutaneous nerve.
Which cords give rise to the median nerve?
Lateral cord and medial cord.
How does the journey of the median nerve go?
it runs laterally to the brachial nerve, in the middle of the arm it crosses to the medial aspect and enters into the cubital fossa
What does the median nerve innervate?
Flexor muscles in the forearm (except flexor carpi ulnas and median third of flexor digitorum profundus).
What does the ulnar nerve innervate?
Flexor carpi ulnas and half of flexor digitorum profundus.
What is the position of the long, lateral and medial head of the triceps?
Long head is medial, lateral head is lateral, medial head is in the middle.
Where is the cannon tendon of the triceps inserted into?
The olecranon.
What muscle aids the triceps in extension at the elbow?
Anconeus.
What does the radial nerve innervate?
The extensor muscles of the elbow and wrist.
Brachioradialis
What is the journey of the radial nerve?
In the radial groove, into the cubital fossa.
Where does the ulnar nerve run behind?
The medial epicondyle.
What is seen in radial nerve injuries?
Wrist drop
Which nerve will be damaged in a surgical neck fracture?
Axillary nerve
Which nerve will be damaged in a medial epicondyle fracture?
Ulnar nerve
Which nerve will be damaged in a spiral groove fracture?
Radial nerve.
What is the 3 muscles that flex the elbow?
Biceps brachii, brachioradialis, brachialis.
What are the ligaments of the elbow?
annular ligament
radial collateral
ulnar collateral.
What type of joints are the radio ulnar joints?
Both proximal and distal are pivot synovial joints.
proximal - supported by the annular ligament.
What are the attachments of the biceps brachii?
Long head - supraglenoid tubercle, short head - coracoid process.
common tendon - radial tuberosity of the radius.
What is the main flexor of the elbow joint?
The brachialis.
Which muscle of arm is a powerful supinator?
the biceps
Which muscles causes pronation?
pronator theres and pronator quadrates
What two muscles have a common origin in the coracoid process?
The coracobrachialis and the short head of the biceps.
which bursa communicates with the shoulder joint?
The subscapular.
