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GSSE anatomy 1 > Upper limb > Flashcards

Upper limb Flashcards

1
Q

What are the two sites of origin of the pectoralis major muscle?

A

the sternal-manubrial head and clavicular head

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2
Q

the nerve supply to the pectoralis major is ?

A

from the brachial plexus via the medial and lateral cords of the plexus
the medial cord pierces deep and goes into pec minor and supplies it.
the only muscles in the upper limb to be supplied by all 5 segments of the brachial plexus.
C5-C6 the clavicular head adn C7 8 and T1 the sternalcostal part

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3
Q

explain the insertion of the pec major onto the humerus

A

trilaminar insertion
quite complicated,
the clavicular head makes the most anterior part and the sternal head makes a loop behind

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4
Q

what ribs does pec minor originate on ?

A

3rd, 4th adn 5th ribs

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5
Q

What is the insertion of pec min?

A

the coracoid process and the humerus

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6
Q

what are the 4 branches of the thoracoacoacromial artery

A

clvicular
humeral
acromial adn
pectoral

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7
Q

what 4 structures peirce the infrclaviculr fossa>

A

2 in - lymphatics from subclavian and cephalic vein

2 out - the lateral pectoral nerve and the thoraco acromial vessels.

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8
Q

the most superior attachment of the trapezius is to the?

A

superior nuchal line and crest on the occiput.

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9
Q

what is the trapezius attached to medially?

A

the supraspinatus ligaments on the spinus processes down to T12

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10
Q

what attachment does the trapezius have to the scapula?

A

around the spine of the scapula above and below.

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11
Q

Which vertebral level does the lat dorsi commence?

A

T7

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12
Q

what is the most inferior part of the origin of lat dorsi?

A

the mesial 1/3 of the iliac crest.

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13
Q

what type of joint is the sternoclavicular joint? and why is it atypical?

A

it is a synovial joint, however it is lined with fibrocartilage not hyaline. and
there is a fibrocartilagenous disc dividing the two cavaties

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14
Q

a fall which dislocates the acromium behind the calvicle will tear which ligament?

A

the coraco clavicular ligmaent

Which is made up out of the conoid part and the trapezoid part

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15
Q

what side of the scapula is the subscapularis on?

A

the costal side
therefore its attachment is on the anterior surface of the humerus. in the medial tuberosity therefore it is a medial rotator

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16
Q

which side of the scapula does the teres major muscle arrise from?

A

the dorsal side, but attaches to the anterior part of the humerus so therefore it is a medial rotator.

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17
Q

when does the auxillary artery become the brachial?

A

at the lower border of teres major

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18
Q

in the axilla is the vein anterior or posterior to the artery?

A

vein is anteriro to the artery

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19
Q

which fascial layer in the neck projects down to become to axillary sheath ?

A

the prevertebral fascia.

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20
Q

the teres minor origin is on which side of the scapula and inserts on which part of the humerus?

A

the lateral 1/3 of the middle scapula, then attaches under the teres major on the anteror of the humerus on the medial tuberosity
this means that it is a lateral rotator.

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21
Q

the brachial cords enter the axilla in what relation to the axillary artery?

A

above it

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22
Q

what arteries come off the three parts of the axillary artery ?

A

1st part: 1 artery : superior thoracic artery runs forward to suply the pecs
2nd part : 2 arteries : the thoracoacromial (4 branches) and lateral thoracic arteries (breast)
3rd part: 3 arteries : subscapular artery and the anterior and posterior circumflex

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23
Q 
at which locations do each of the divisions occur?
roots
trunks
divisions
cords
A

roots: between the scalenes
trinks: in the triangle
divisions: behind the clavicle and
cords: in the axilla

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24
Q

where does the supraspinatus insert?

A

the greater tuberosity of the humerous

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25
Q

what is the innervation of the supraspinatus muscle?

A

C5- C6 from the upper trunk

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26
Q

is the subscromial bursae above or below the spuraspinatus muscle inthe shoulder

A

above in the distal 1/4th of the muscle

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27
Q

where does the inraspinatus muscle attach to the smooth area on the central facet of the greter tuberosity of the humerus, ?

A

below supraspinatus and above teres minor

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28
Q

which muscle attaches lower on the acapula? teres minor or teres major?

A

Teres major is lower adn teres minor it above it with 2 attachment sites which are on the lateral scapula

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29
Q

does the median nerve give off any branches in the arm?

A

no its first branch that it give off is in the forearm and that is nerve to pronator teres.

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30
Q

the ulna nerve passes over or under the flexor retinaculum inthe wrist?

A

over it

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31
Q

the second part of the axillary artery sits behind which muscle?

A

pec minor

it gives off two arteries here: 1 thoracocarcmial and 2 lateral thoracic

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32
Q

the radial artery in the forearm runs superficial or deep to the brachioradialis?

A

deep to brachioradialis

the radial nerve also runs deep to brachioradialis

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33
Q

the ulna artery runs superficial or deep to the pronator teres?

A

the ulna artery runs deep to the pronator teres.

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34
Q

the deep and superifial palmer arches are supplied by which arteries in the hand?

A

the deep is radial adn the superificial is the ulna

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35
Q

the tendon associated with De Quervains tonesinuvtis is?

A

the abductor policis longus

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36
Q

what are the order of structures in the cubital fossae? lateral to medial ?

A

bicepts tendon then radial artery then medial nerve, nerve being most medial.

Note the radial nerve is over on the most lateral side hidden under the brachioradialis.

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37
Q

the anatomical snuff box is located between which two tendons?

A

extansor policis longus and extensor policis brevis

38
Q

the radial artery lies on which 2 hand bones?

A

the scaphoid and trapezium

39
Q

which superficial nerves goes over the anatomical snuff box?

A

the superficial radial artery traverses the snuff box

40
Q

what nerve and artery are in guyons canal

A

the ulna nerve and artery

41
Q

what is deep to the lexor retinaculum under guyons canal?

A

the 4 tendons of the flexor digitorum superficialis

the 4 tendons of the flexor digitorum profondus are fanned out under that

42
Q

the median nerve sits under the flexor retunaculum with a tendon either side. What tendons?

A

medially is the bundle of flexor digitorum superficialis and on the lateral side is the flexor carpi radialis Iin (in its own compratment)

43
Q

the 4 bony points of the attachment of the flexor retunaculum are
?

A

on the medial side and hamate adn pisiform and on the lateral side the scapoid and trapezium

44
Q

pec minor is supplied by which nerves?

A

both medial and lateral pectoral nerves. C 6, 7, 8

45
Q

the long thoracic nerve is also called ?

A

the nerve to serratus anterior

46
Q

the thoraco dorsal nerve is from the posterior nerve cord and is also known by which name?

A

nerve to latissimus dorsi

47
Q

the nerve supply to the axilla is via which nerve which needs to be excised in a therapeutic axilary clearance?

A

intercostal brachial nerve

48
Q

why does a scapular fracture result in a haematoma which is confined limited to the margins of the bone?

A

because of the infraspinatus fascia which covers the infrastintus muscle and the teres minor

49
Q

paralysis in what muscle cuases the scapula to wing out?

A

the serratus anterior

50
Q

where does the rhomboid major muscle attach to compared to the rhomboid minor?

A

major attaches to the inferior angle of the scapula and the minor attaches to the medial border of the spine of the scapula

51
Q

the ulnar nerve is always on which side of the ulnar artery?

A

the ulnar side

52
Q

is it the palmer or dorsal ilterosseous muscles which are responsible for adduction of the fingers?

A

the palmer is for adduction dorsal is for abdustion (dolphin abducting you)
Both are supplied by the ulna nerve

53
Q

where does the brachialis attach in the forearm?

A

on the coronoid process of the tuberosity of ulna, after it has covered the anterior elbow joint.

54
Q

the innervation of the brachialis muscle is by which nerve?

A

musculocutaneous, from C5-6, the lateral cord.

55
Q

the medial intramuscular septum is pierced by ?

A

the ulna collateral artery adn ulna nerve

56
Q

the lateral intramuscular sepstum is pierced by

A

the radial nerve and the profunda brachii artery.

57
Q

what 2 structures go through the pronator teres int he forearm?

A

the ula artery and the medial nerve

58
Q

discribe the relationship of the medial nerve to the brachial artery?

A

it begins lateral and then becomes medial going anterior to the artery, in the ACF it is medial

59
Q

in the froearm the median nerve traverses inbetween the tendons of which two muscles?

A

it runs under flexor digitorum superficialis (with the ulna artery) and flexor digitorum profundus medially at the wrist

60
Q

what is the cutaneous disctrbution of the medial nerve in the hand?

A

the medial palmer side of the thumb and 2.5 fingers and the tips of those fingers on the volar side

61
Q

What nerve supplies the bicepts, chorachbrachialis, brachialis?

A

the musculocutaneous nerve

62
Q

what is the relation of the ulna nerve in relation to the brachial artery in the arm?

A

anways medial to it.

63
Q

what muscle in the forearm does the ulna nerve traverse through after it has gine behind the medial intramuscular septum ?

A

flexor carpi ulnaris (it also gives this nerve innervation)

64
Q

the superficial innervation of the skin on the hand from the ulan nerve is?

A

the pinky finger and half the ring finger.

65
Q

which nerve in the hand grooves the hook of the hammate?

A

the ulna nerve

66
Q

the root of the radial nerve which supplies the tricepts muscle is?

A

C7 - C8

67
Q

what does the musculocutaneous nerve in the arm become in the forearm?

A

the lateral cutaneous nerve of forearm

68
Q

the ulna nerve sits under which muscle inthe forearm?

A

the flexor carpi ulnaris

69
Q

the radial nerve and the profunda brachii are between which two heads of the tricepts?

A

the medial and lateral head

70
Q

what nerve is covered by the brachioradialis muscle in the cubi fossa?

A

the radial nerve

71
Q

the radial nerve traverses through the two heads of which muscle just past the acf?

A

supinator

72
Q

the radial nerve goes above or below brachio-radialis?

A

below brachio-radialis in the forearm

73
Q

which nerve pronates the arm?

A

the medial nerve c6 C7 innervates the pronator teres

74
Q

the flexor digitorum superficialis is unnervated by which nerve

A

median

75
Q

What is the blood supply to the tricepts?

A

the profunda brachii

76
Q

the 5 superficial muscles of the wrist flexors have a common origin, what is it?

A

the medial condile of the humerus at its anterior surface.

77
Q

the common interosseous artery in the forearm comes from which main artery?

A

The ulna artery

78
Q

the superifical skin on the ulna and radial side of the hand and forearm drain into which lymph node group?

A

the ulna side drains into the basilic vein pathway to the supratrochlear nodes
the radial side the lymphatics run along side the cephalic vein to the deltopectoral and infraclavicular lymph nodes.

79
Q

what muscles and nerve is responsibe for the funciton of supination?

A

supinator and bicepts: musculocutameous nerve and radial nerve

80
Q

where is the common origin of the extensor compartment of the arm?

A

the front of the lateral epicondyle

81
Q

is the extansor retinaculum attached to the ulna bone?

A

no, it is attached to the pisiform and triqurtral bones

82
Q

Erbs palsy is an injury to which part of the brachial plexus?

A

C5-6

83
Q

if there is an isolated nerve injury to the axillary nerve, such as in 5% of shoulder dislocations, what anaesthethesia area would this exhibit?

A

an egg sized area on the outer upper arm under the acromium.

84
Q

what is the characteristic finding of a radial nerve injury?

A

wrist drop, inability to extend the wrist

85
Q

what is the classical sign of an ulna nerve lesion?

A

claw hand with hyperextension of the metacarpophalyngeal joints of the ring and middle fingers and flexion of the interphalyngeal joints bacause the interossei and lumbricles are innerveted by the ulna.

86
Q

which 2 muscles in the forearm are innervated by the ulna not the medan nerve.

A

the flexor carpi ulnaris and half of the flexor digitorum produndus

87
Q

if you had an injury to the median nerve high up could you pronate the forearm?

A

no

88
Q

what muscle in the forearm is the median nerve adhered to the bottom of?

A

flexor digitorum superficialis

89
Q

if there is injury to the median nerve what position will the hand be held in?

A

the pointing finger. all other fingers flexed.

90
Q

why does a fracture across the waist of the scaphoid cause avascular necrosis?

A

because the blood supply is from perforating vascular foramina which are more numerous distally and therefore poor blood supply if there was to be a scaphoid fractue.

91
Q

what carpal bone directly articulares with the first metacarpal?

A

the trapezium

92
Q

which carpal bone offifies first and last?

A

the capitate in the first year

pisiform last 10th year

GSSE anatomy 1 (3 decks)

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