Upper Limb Flashcards
What makes up the shoulder girdle?
Scapula
Clavicle
Proximal humerus
What does the clavicle join?
Scapula and sternum
Connects the upper limbs to the axial skeleton
What is the difference between the medial and lateral ends of the clavicle?
Medial end is rounded
Lateral end is flattened
Name another way to tell the difference between the medial and lateral clavicles.
Medial 2/3 of clavicle is convex forwards
Lateral 1/3 of clavicle is concave forwards
How do we tell the difference between the upper and lower surfaces of the clavicle?
Upper surface is smooth
Lower surface is rough
What are the two ends of the clavicle called?
Medial - sternal facet
Lateral - acromial facet
Name some other features of the clavicle.
Conoid process
Subclavian groove
Costal tuberosity
What is the cavity called where the head of the humerus sits?
Glenoid cavity/fossa
What two fossas does the scapular spine make on the posterior surface?
Supraspinous fossa and infraspinous fossa
What does the acromion process articulate with?
Clavicle
What is the notch called on the scapula (near the corocoid process)?
Suprascapular notch
What is the joint called where the sternum attaches to the axial skeleton?
Sternomanubrium joint
What is a common place for fracture in the humerus?
Surgical neck
Differentiate between the coracoid process, conoid and coronoid.
Coracoid process on scapula
Conoid on clavicle
Coronoid process on ulna
Why type of joint is the sternoclavicular joint?
Synovial saddle joint
What does the sternoclavicular joint join?
Joins the clavicle to the sternum and first costal cartilage
Name the ligaments associated with the sternoclavicular joint.
Anterior sternoclavicular ligament
Costoclavicular ligament
Interclavicular ligament
What type of joint is the acromioclavicular joint?
Synovial plane joint
What ligament is associated with the acromioclavicular joint?
Coracoclavicular ligament
What is the coracoclavicular ligament made of?
Trapezoid and conoid ligaments
Which ligament is more lateral, trapezoid or conoid?
Trapezoid
Conoid appears to twist
What type of joint is the glenohumeral joint?
Ball and socket
Head of humerus and glenoid fossa
Which way is the glenohumeral joint prone to dislocating?
Anteriorly
Which way is the hip prone to dislocating?
Posteriorly
What stabilizes the shoulder joint?
Rotator cuff muscle attachments
Long head of biceps and triceps
Ligaments and coracoacromial arch
Glenoid labrum (increases size of glenoid fossa with dense CT), deltoid
What is the function of the subacromial bursa?
Facilitate the movement of the supraspinatus tendon
Prevents the supraspinatus tendon from rubbing on arch
What is the function of the subscapular bursa?
Prevents the subscapular tendon from rubbing against bone
Name the muscle attachments between the axial skeleton and scapula.
Trapezius Rhomboid minor Rhomboid major Levator scapulae Pectoralis minor Serratus anterior
Name the attachments of the trapezius.
Attached to vertebral spines and external occipital protrusion of skull
Attaches to lateral part of clavicle, acromion process and spine of scapula
What is the function of the trapezius?
Upper fibres elevate shoulder girdle
Middle fibres retract shoulder girdle
Lower fibres depress shoulder girdle
What innervates the trapezius?
11th cranial nerve
Describe the attachments of the rhomboid minor and major.
Transverse processes of vertebrae to medial border of scapula
Which rhomboid is superior?
Rhomboid minor
What is the function of the rhomboids?
Retraction of the shoulder girdle
What does the serratus anterior do?
Protraction of the shoulder girdle
Describe the attachments of the serratus anterior.
Upper 8/9 ribs
First 3 bellies attach to superior angle/medial border
Rest attach to inferior angle
Describe the attachments of the serratus anterior.
Upper 8/9 ribs
First 3 bellies attach to superior angle/medial border
Rest attach to inferior angle
What muscle if paralyzed causes winging of the scapula?
Serratus anterior
Where does the pectoralis minor attach?
Tip of the coracoid process
Ribs 3, 4 and 5
What is the function of the pectoralis minor?
Protraction and depression of the shoulder girdle
Name the muscles between the scapula and humerus
Rotator cuff muscles
Teres major
Name the rotator cuff muscles.
Supraspinatus
Infraspinatus
Subscapularis
Teres minor
What is the function of the supraspinatus?
Abductor
What are the attachments of the supraspinatous muscle?
Supraspinous fossa
Attaches to greater tuberosity of humerus
What other thing must I remember about the supraspinous muscle?
It has a supraspinatous tendon which blends into the ligaments
What tendons do I need to remember at the glenohumeral joint?
Tendon of the long head of the biceps
Supraspinatous tendon
What is the function of the subscapularis?
Medial rotator
Name the attachments of the subscapularis.
Subscapular fossa
Attaches to lesser tuberosity of humerus and medial border of scapulae
What is the function of the infraspinatous?
Lateral rotator
What are the attachments of the infraspinatous?
Infraspinous fossa
Attaches to greater tuberosity and medial border
What is the function of the teres minor?
Lateral rotator
What are the attachments of the teres minor?
Greater tuberosity of the humerus
What is the function of the teres major?
Adducts and medially rotates the arm
What are the attachments of the teres major?
Inferior angle to intertubercular sulcus
What are the muscles between the axial skeleton and humerus?
Pectoralis major
Latissimus dorsi
What is the function of the latissimus dorsi?
Adductor of humerus
Name the attachments of the latissimus dorsi.
Attached to lower vertebral column, sacrum and iliac crest
Attaches to intertubercular groove
Name the three parts of the pectoralis major.
Clavicular head
Sternocostal head
Abdominal part
What is the function of the pectoralis major?
Adduction and medial rotation of the humerus
What is the pectoralis major attached to?
Intertubercular groove
Clavicle
Sternum
Ribs
What shape is the apex and what is it made up of?
Pyramidal shaped region with 4 walls, an apex and base.
Name the parts making up the walls, base and apex of the axilla.
Anterior wall - pec major/minor
Posterior wall - scapula/teres major/latissimus dorsi/subscapularis
Lateral wall - intertubercular groove of humerus where there are attachments for pec major, latissimus dorsi and teres major)
Medial wall - thoracic wall/serratus anterior
Apex - entrance from the base of neck to axilla, lies between 1st rib, clavicle and superior edge of subscapularis
Base - armpit formed by skin, subcutaneous tissue and axillary fascia extending from arm to thoracic wall
Name the muscles between the humerus and scapula.
Rotator cuff muscles (supraspinous, infraspinous, subscapularis, teres minor)
Teres Major
What is the function of the supraspinous?
Abductor
Where does the supraspinous muscle attach?
Greater tuberosity of humerus
What is the function of the subscapularis?
Medial rotator
What does the subscapularis attach to?
Medial border of scapula, lesser tuberosity of humerus
What is the function of the infraspinous?
Lateral rotator
Where does the infraspinous attach?
Greater tuberosity and medial border
What is the function of the teres minor?
Lateral rotator
What is the function of the teres major?
Adducts and medially rotates the arm
Above the inferior angle to intertubercular sulcus
What is the function of the deltoid?
Anterior fibres - flex the arm
Middle fibres - abduct the arm
Posterior fibres - extend the arm
Where is the subclavius found?
Above and medial to pec minor
Passes the first rib, laterally and slightly upwards to inferior surface of clavicle
What passes through the axilla?
Blood vessels and nerves which supply the upper limb
Neck –> axilla –> UL
Describe the arterial supply of the upper limb.
Brachiocephalic trunk branches to form subclavian artery on right side.
Arch of aorta branches to form subclavian artery on left side.
Subclavian artery –> axillary artery (from outer border of 1st rib) –> brachial artery from lower border of teres major
Describe the veins of the upper limb.
Subclavian vein –> axillary vein –> brachial vein
And superficial veins
Name the movements of the anterior compartment of the arm.
Flexion of elbow
Supination
Name the innervation and supply of the anterior compartment of the arm.
Musculocutaneous nerve
Brachial artery
Name the muscles of the anterior compartment of the arm.
Biceps brachii
Coracobrachialis
Brachialsis
What is the most powerful supinator?
Biceps brachii
What is the most powerful elbow flexor?
Brachialis
Where does the long head of the biceps brachii tendon travel?
Travels in the intertubercular groove and attaches above the glenoid fossa
Where does the distal part of the biceps brachii attach?
tuberosity of radius
Name the attachments of the short head of the biceps brachii.
Joins with coracobrachialis to make tendon joining the tip of the coracoid process
Bicipital aponeurosis remember this!!
What does the brachialis attach to?
Coronoid process of the ulna
Name the innervation and supply of the posterior compartment of the arm.
Radial nerve
Profunda brachii artery
What are the muscles of the posterior compartment of the arm?
Triceps - lateral head, long head and medial head (deep)
What do the triceps attach to and what movements do they perform?
Attach to the olecranon process of the ulna
Extension of the arm/forearm
Pronator teres
Median nerve
Medial epicondyle and coronoid process of ulnar to lateral side of radius
Ulnar and radial artery
Pronation of forearm
What is the most lateral structure in the carpal tunnel?
Tendon of flexor carpi radialis
Flexor carpi radials
Medial epicondyle to base of 2nd/3rd metacarpals
Median nerve
Radial artery
Wrist flexion and wrist abduction
Palmaris Longus
Medial epicondyle to palmar aponeurosis
Median nerve
Ulnar and median artery
Flexor carpi ulnaris
Medial epicondyle to pisiform
Ulnar artery
Ulnar nerve
Flexor digitorum superficialis
Medial epicondyle, ulnar collateral ligament, coronoid process, oblique ridge on radius
Ulnar artery
Median nerve
Flexor digitorum profundus
Deep to flexor digitorum superificialis Attach to phalanges Medial 2 digits = ulnar nerve Rest = Median nerve Ulnar artery
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