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Anatomy > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

Name the muscles that connect the upper limb to the thoracic wall

A

Pectoralis major
Pectoralis minor
Subcalvius
Serratus anterior

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2
Q

Origin and insertion of the pectoralis major muscle

A

Origin: two heads claviclular head from medial half of the front of the clavicle and sternocostal head from sternum upper six costal cartilages and apponeurosis of external oblique muscle.

Insertion: lateral lip of bicepital groove of the humerus.

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3
Q

NS and NR of perctoralis major muscle

A

NS medial and lateral pectoral nerve

NR c5 c6 c7 c8 and t1

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4
Q

Action of pectoralis major muscle

A

Addiction and medial rotation of the arm

Clavicular head helps in flex ion of the arm (shoulder)

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5
Q

Pectoralis minor origin and insertion

A

Origin: from 3rd 4th and 5th ribs close to their costal cartilages.
Insertion: Coracoid process of the scapula

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6
Q

NS and NR of pectoralis minor

A

NS medial pectoral nerve from brachial plexus

NR c6 c7 c8

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7
Q

Action of pectoralis minor

A

Depression of the shoulder

Draws the ribs upwards and outwards during deep inspiration.

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8
Q

Origin and insertion of subclavius

A

Origin: first costal cartilage
Insertion: subcalvian groove in the middle 1/3 of the inferior surface of clavicle.

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9
Q

NS of subclavius

A

Nerve to sublclavius from upper trunk of brachial plexus

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10
Q

Action of subclavius

A

Fixes the clavicle during movement of the shoulder joint.

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11
Q

Serratus anterior origin and insertion

A

Origin: upper eight ribs
Insertion: anterior aspect of the medial border and inferior angle of scapula.

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12
Q

Serratus anterior NS

A

Long thoracic nerve.

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13
Q

Serratus anterior action

A

Draws the scapula forward in boxing (protrusion)

Rotates the scapula outwards in raising the arm above 90*

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14
Q

What is the clavipectoral fascia

A 
It is a thickened membrane of deep fascia between the subclavius and perctoralis minor 
It is pierced by 
Lateral pectoral nerve 
Thoraco-acromial artery 
Cephalic vein 
Few lymph vessels
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15
Q

The root of brachial plexus

A

Formed by the anterior rami (branch) of c5, c6, c7, c8 and t1

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16
Q

Trunks of brachial plexus in details and divisions

A

Upper (superior) trunk: formed by the union of the anterior rami of c5 and c6

Middle trunk: anterior ramus of c7

Lower (inferior) trunk: formed by the union of the anterior rami of c8 and t1.

Division: each trunk is divided into anterior and posterior divisions.

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17
Q

Cords of brachial plexus in details

A

Lateral cord: formed by the union of the anterior divisions of the upper and middle trunk

Posterior cord: formed by the union of the posterior division of all trunks.

Medial cord: formed by the anterior division of the lower trunk

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18
Q

Describe the axilla in general

A

Known as the armpit a pyramid shape space between the upper part of the arm and the side of the chest. It’s a communication between the upper limb and the root of the neck.
Has an apex (inlet) base and four walls: anterior posterior medial and lateral.

19
Q

The folds of the axilla are formed by

A

The anterior fold of the axilla is formed by the folded fibers of the pectoralis major muscle

The posterior fold of the axilla is formed by the folding of the latissimus dorsi over teres major muscle.

The anterior fold is higher than the posterior fold

20
Q

The anterior wall of the axilla is formed by the

A

Pectoralis major
Pectoralis minor
Subclavius
Clavipectoral fascia

21
Q

The posterior wall of the axilla is formed by the

A

Subscapularis
Teres major
Lattissimus dorsi
Proximal part of the long head of triceps

22
Q

Openings in the posterior wall of the axilla the quadrangular space is bounded by… and transmits

A

Subscapularis
Surgical neck of the humerus
Teres major
Long head of triceps

And transmits the axillary nerve and posterior circumflex humeral artery.

23
Q

Openings in the posterior wall of the axilla the triangular space is bounded by … and transmits

A

Long head of triceps
Subscapularis
Teres major

Transmits circumflex scapular artery and vein.

24
Q

The medial wall of the axilla is formed by

A

Upper 4-5 ribs

Upper 4-5 intercostal spaces covered by the upper digitations of the Serratus anterior muscle.

25
Q

The lateral wall of the axilla is formed by

A

It is the narrowest wall
Biciputal groove
Coracobrachialis
Biceps brachii

26
Q

What are the contents of the axilla (7)

A

Axillary artery and it’s branches
Axillary vein and it’s tributaries
Axillary tail of the breast
Cords and terminal branches of the brachial plexus
Axillary lymph vessels and lymph nodes
Axillary fat
Lateral cutaneous branches of the upper intercostal nerves.

27
Q

Begging course and termination of the axillary artery

A

Beginning: at the outer (lateral) border of the first rib as a continuation of the subclavian artery.

Corse: passes downwards in the axilla from the apex to the base.

Termination: ends at the lower border of the teres major muscle where it continuous as the brachial artery.

28
Q

Parts of the axillary artery

A

Divided by pectoralis minor into three parts
First part: lies above the pectoralis minor

Second part: lies behind the pectoralis minor

Third part: lies below the pectoralis minor.

29
Q

Relations o father first part of the axillary artery

A

The first part lies above the pectoralis minor

Anteriorly: the clavicular part of the pectoralis major the clavipectoral fascia and vessels and nerves superficial to it.

Posteriorly: first intercostal space, first digitation of the Serratus anterior and medial cord the brachial plexus.

Laterally: lateral and posterior cords of the brachial plexus.

Medially: axillary vein.

30
Q

Relations of the second part of the axillary artery

A

The second part of the axillary artery lies behind the pectoralis minor

Anteriorly: the pectoralis minor and major

Posteriorly: the posterior cord of the brachial plexus and the Subscapularis muscle.

Laterally: the lateral cord of the brachial plexus.

Medially: the medial cord of the brachial plexus, medial pectoral nerve and axillary vein.

31
Q

Relations of the third part of the axillary artery

A

The third part of the axillary artery lies below the pectoralis minor.

Anteriorly: upper part is covered by pectoralis major but it’s lower part is covered by skin, superficial and deep fascia. It’s crossed by the medial root of the median nerve.

Posteriorly: the Subscapularis, the lattismus dorsi and the teres major. The axillary and radial nerves also lies behind the artery.

Laterally: the coracobrachialis p, the biceps and the humerus. The lateral root of the median and musculocutaneous nerves also lie in the lateral side.

Medially: the ulnar nerve, axillary vein and the medial cutaneous nerve of the arm and the forearm.

32
Q

Branches of the axillary artery in the first part

A

The superior thoracic artery.

33
Q

Branches of the axillary artery in the second part

A

The thoracoacromial trunk

The lateral thoracic artery

34
Q

The branches of the axillary artery in the third part

A

The Subscapular artery
The anterior circumflex humeral artery
The posterior circumflex humeral artery

35
Q

The beginning and end of the axillary vein

A

Beginning: at the lower border of teres major as a continuation of basilic vein.

End: the outer border of the first rib where it becomes subclavian vein.

It lies on the medial side of the axillary artery.

36
Q

The tributaries of the axillary vein

A

Two vanae comitantes of brachial artery, cephalic vein and other tributaries follow the axillary arterial branches.

37
Q

Muscles that connect the scapula to the humerus (6)

A 
Deltoid 
Supraspinatus
Infraspinatus 
Teres major 
Teres minor 
Subscapulrais
38
Q

Superficial muscles of the shoulder are

A

Trapezius and deltoid muscles. Together they provide the characteristic contour of the shoulder. The trapezius attaches the scapula and clavicle to the trunk. The deltoid attaches the scapula and clavicle to the humerus.

39
Q

Deltoid muscle, origin insertion and NS, NR

A

Large and triangular in shape, with its base attached to the scapula and clavicle and it’s apex attached to the humerus.

Origin: lateral third of clavicle, acromion and spine of the scapula (U shaped).

Insertion: middle of the lateral surface of shaft of humerus (deltoid tuberosity).

NS: axillary nerve c5 and c6 (branch of posterior cord of the brachial plexus).

40
Q

Action of deltoid muscle

A

Performs three functions because of the direction of its fibers

  • posterior fibers extend and laterally rotate the arm (shoulder)
  • middle fibers abducts arm 15 to 90
  • Anterior fibers flex and Medially rotate arm 
41
Q

Structures under cover of the deltoid muscle

A 
Bone: Upper part of humerus 
Coracoid process 
Greater tuberosity 
Lesser tuberosity 
Intertuberculus sulcus (groove)

Bursa: subdeltoid
Subacromial bursa

Muscles: teres minor
Teres major
Lattismus dorsi
Triceps long head

Vessels: anterior and posterior circumflex humeral vessel.

Nerves: axillary nerve.

42
Q

Trapezius origin, insertion and nerve supply

A 
Origin: external occipital protuberance 
Superior nuchal line 
Ligamentum nuchae 
Spine of the 7th cervical vertebra
Spines of all thoracic vertebrae and their supraspinous ligament

Insertion: U shaped insertion opposite to the origin of the deltoid.
Upper fiber into the posterior border of lateral third of clavicle.
Middle fibers, medial border of acromion and upper lip of the crest of the spine
Lower fibers, pass upward and laterally insert on medial end of the spine of the scapula.

Nerve supply: spinal part of accessory nerve (motor) XI
Ventral rami of C3 and c4 (sensory- proprioceptive)

43
Q

Action of the trapezius muscle

A

Upper fibers along with lavator ‏scapulae elevate the scapula
Middle fibers with rhomboids pull scapula Medially (retracts)
Lower fibers pull medial border of scapula downward, so upper and lower fibers acting together rotate scapula glenoid cavity face upward assisted by lower five digitations of Serratus anterior. 

Anatomy (2 decks)

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