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FCS (SA) Primaries > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

Name the borders of the axilla

A

Apex (axillary inlet) - lateral border 1st rib, superior border scapula, posterior border clavicle

Lateral wall - intertubercular groove humerus

Medial wall - serratus anterior and thoracic wall

Anterior wall - pectoralis major, minor, subclavius

Posterior wall - subscapularis, teres major, latissimus dorsi

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2
Q

Name the contents of the axillary artery

A 
Axillary artery and branches
Axillary vein and branches
Brachial plexus and branches
Axillary lymph nodes
Biceps brachi (short head), coracobrachialis
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3
Q

The quadrangular space is a gap in the posterior wall of the axilla.

Which structures pass through the quadrangular space?

A

Axillary nerve

Posterior circumflex humeral artery

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4
Q

What are the borders of the clavicopectoral triangle?

A

Clavicle, pectoralis major and deltoid muscle

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5
Q

Which structures pass through the clavicopectoral triangle?

A

Cephalic vein

Medial and lateral pectoral nerves

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6
Q

Name the borders of the cubital fossa

A

Superior - line drawn between the humeral epicondyles
Lateral - brachioradialis (medial border)
Medial - pronator teres (lateral border)
Roof - bicipital aponeurosis, fascia, subcutaneous fat and skin
Floor - brachialis (proximally) supinator (distally)

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7
Q

List the contents of the axillary triangle from lateral to medial

A

Radial nerve - divides into superficial and deep
Biceps tendon - attached onto radial tuberosity
Brachial artery - bifurcates into radial and ulna artery at the apex
Median nerve

Roof contains median cubital vein which connects basilic and cephalic vein

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8
Q

The ulna tunnel is a fibro-osseous space located in the poster-medial aspect of the elbow

    1. Name it’s border
    1. Contents
A

1.1.

Medial - Medial epicondyle
Lateral - olecranon
Floor - joint capsule, medial collateral ligament
Roof - arcuate ligament of Osborne or cubital tunnel retinaculum (medial epicondyle to olecranon)

1.2. Ulna nerve

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9
Q

Define cubital tunnel syndrome and it’s clinical features

A

Cubital tunnel syndrome refers to the compression of the ulna nerve with the cubital tunnel.

Clinical features:

Pain
Paraesthesia - medial 1 and a half fingers
Weakness and wasting of intrinsic hand muscles

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10
Q

What are the borders which make up the carpal tunnel?

A

The deep carpal arch

Medially - hook of hamate and pisiform
Laterally - scaphoid and trapezium

Flexor retinaculum - roof

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11
Q

List the contents of the carpal tunnel

A

FDS
FDP
FPL
Median nerve - palmer cutaneous branch given off pior to carpal tunnel

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12
Q

Name the terminal divisions of the Median nerve

A

Palmer digital nerve -
Sensory - palmer skin and dorsal nail beds of lateral 3 and a half digits
Recurrent branch - supplies thenar muscle group

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13
Q

Name the borders of the anatomical snuffbox

A

Medial (ulna) border - Extensor Pollicis Longus

Lateral (radial) border - Abductor Pollicis Longus, Extensor Pollicis Brevis

Floor - scaphoid, trapezium

Proximal border - radial styloid process

Roof - skin

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14
Q

Contents of the anatomical snuff box

A

Radial artery
Superficial branch radial nerve
Cephalic vein

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15
Q

Thoracic outlet syndrome occurs when the contents passing through the the axillary inlet become compressed between the bones.

    1. List common causes
    1. Describe the clinical picture
A

1.1.
Trauma e.g. fractured clavicle
Repetitive movements
Cervical rib

1.2.
Pain in affected limb
Tingling 
Muscle weakness
Discolouration
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16
Q

Approximately 75% of lymph from the breast drains into the axilla.

    1. Which nerve is susceptible to injury during an axillary clearance?
    1. Which muscle is innervated by this nerve?
A
    1. Long thoracic nerve

1. 2. Serratus anterior

17
Q

Which muscles attach onto the greater tuberosity?

A

Supraspinatus
Infraspinatus
Teres minor

Attach onto the superior, middle and inferior facets respectively

18
Q

Which muscles attach onto the lesser tuberosity?

A

Subscapularis

19
Q

The intertubercular sulcus separates the greater and lesser tuberosity with it’’s edges are known as the medial and lateral lips.

    1. Which structure runs through this groove?
    1. Which muscle(s) attaches to the medial and lateral lips
A
    1. Tendon of long head of biceps
    1. “A lady between 2 majors”

Medial lip - teres major, latissimus dorsi
Lateral lip - pectoralis major

20
Q

Which neurovascular structures are at risk during a fracture of the surgical neck of humerus?

A

Axillary nerve

Posterior circumflex humeral artery

21
Q

The radial groove is a shallow depression which runs diagonally on the posterior aspect of the humerus.

Which anatomical structure(s) run in this groove?

A

Radial nerve

Profunda brachi artery

22
Q

Supracondylar fractures can result in injury to which anatomical structure(s)?

A

Brachial artery
Anterior interosseous nerve (branch of Median nerve)
Ulna nerve
Radial nerve

23
Q

Supracondylar fractures can result in injury to which anatomical structure(s)?

A

Brachial artery
Anterior interosseous nerve (branch of Median nerve)
Ulna nerve
Radial nerve

24
Q

How does one test the anterior interosseous nerve?

Which muscle is innervated by AIN?

A

Ask the patient to make the “OK” sign

Tests weakness in the FPL

25
Q

The distal end of the radius articulates with which carpal bones to make up the wrist joint?

A

Scaphoid

Lunate

26
Q

Radius and ulna are attached by the interosseous membrane

    1. Describe a Monteggia fracture
    1. Describe a Galeazzi fracture
A
    1. Fracture of the proximal ulna with a proximal radio-ulna joint dislocation
    1. Fracture of the distal radius with the ulna head dislocation at the distal radio-ulna joint
27
Q

Describe a Bennett’s fracture

A

Fracture of the base of the 1st metacarpal - extending into the 1st CMC joint leading to instability or subluxation of the joint - - often requires surgical repair

28
Q

Name the muscles of the thenar eminance and the nerve which innervates them

A

Oponens Pollicis
Abductor Pollicis Brevis
Flexor Pollicis Brevis

Median nerve

29
Q

Name the muscles of the hypothenar eminance and the nerve which innervates them

A

Opponens Digiti Minimi
Abductor Digiti Minimi
Flexor Digiti Minimi Brevis

Ulna nerve

30
Q

The lumbricals of the hand originate on the tendon of FDP and insert onto the extensor hood of it’s corresponding finger.

Denervation of the lumbricals are responsible for ulna claw and hand of benediction.

    1. What are the actions of the lumbricals
    1. Innervation
A

1.1. Flexion of the MCPs and extension of the IP joints

1.2.
Lateral 3.5 - Median nerve
Medial 1.5 - Ulna nerve

31
Q

The interossei muscles originate from the medial and lateral surfaces of the metacarpals and insert into the extensor hood of the proximal phalanx

    1. Actions of the dorsal and palmer interossei
    1. Innervation
A

1.1.
Palmer interossei - adduction
Dorsal interossei - abduction

1.2. Ulnar nerve

32
Q

Which muscles share a common origin at the lateral epicondyle?

A

Extensor carpi radialis brevis
Extensor digitorum
Extensor carpi ulnaris
Extensor Digiti Minimi

33
Q

The extensor compartment of the forearm contains muscles responsible for extension of the wrist and fingers.

    1. Name muscles of the superficial posterior compartment of the forearm
    1. Name the muscles of the deep posterior compartment of the forearm
    1. Innervation
A 
1.1. Superficial group
Brachioradialis
ECRL and ECRB
ED
EDM
ECU
Anconues
1.2. Deep group
Supinator
Abductor Pollicis Longus 
EPL and EPB
Extensor indicis

1.3. Radial nerve

34
Q

The deep muscles of the posterior compartment of the forearm are innervated by the posterior interosseous nerve (branch of radial nerve) except for _______ ?

A

Supinator - innervated by deep branch radial nerve

35
Q

Ulnar nerve arise from C8-T1

    1. Describe it’s anatomical course
    1. 3 branches arising in the forearm
    1. Name the branch arising in the hand
    1. Muscles innervated in the forearm
A

1.1.
Arises from brachial plexus - descends down arm between axillary artery (lateral) and axillary vein (medial)
Proceeds down medial aspect medial to brachial artery
Mid-point forearm - pierces medial fascia to enter posterior compartment arm then passes through cubital tunnel into forearm

Forearm - pierces the 2 head of FCU and gives off 3 branches
Enters hand via Guyons canal - superficial to Flexor retinaculum - medial to ulnar artery

    1. Muscular branch, palmar and dorsal cutaneous branches
    1. Superficial branch
    1. Medial half of FDP, FCU
36
Q

What is Froment’s sign?

A

Tests weakness of ulnar nerve - specifically Adductor Pollicis

37
Q

The Median nerve (C6-T1) is terminal branch of the brachial plexus. Name the branches given off in the…

    1. Forearm
    1. Terminal branches in the hand
A

1.1.
Anterior interosseous nerve
Palmer cutaneous nerve

1.2.
Recurrent branch - innervates thenar muscles
Palmer digital branch - lateral 2 lumbricals, sensation to lateral 3.5 digits and palmer surface and fingertips

FCS (SA) Primaries (19 decks)

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