upper limb Flashcards
what nerve runs close to the surgical neck of the humerus?
axillary nerve
what nerve may be damaged by mid-shaft humeral fractures?
radial nerve
as runs in radial/spiral groove
what movement is produced by the trapezius muscle?
upper fibres elevate scapula
middle fibres retract scapula
lower fibres depress and rotate scapula
action of latissimus dorsi
extends, adducts and medially rotates the humerus
action of levator scapulae
elevation of scapula
action of rhomboid major and minor
elevation of scapula
origin of trapezius
skull, thoracic and cervical vertebrae
insertions of trapezius
clavicle and scapula
origin of latissimus dorsi
lower thoracic vertebrae
insertion of latissimus dorsi
upper anterior humerus
origin of levator scapulae
lower thoracic vertebrae
insertion of levator scapulae
medial border of scapula
origin of rhomboid minor
C7 and T1
insertion of rhomboid minor
medial border of scapula
origin of rhomboid major
thoracic vertebrae
insertion of rhomboid major
medial border of scapula
6 muscles attach scapula to humerus
deltoid teres major teres minor supraspinatus infraspinatus subscapularis
muscles of rotator cuff
teres minor
supraspinatus
infraspinatus
subscapularis
origin of deltoid
lateral 1/3 clavicle
acromion
spine of scapula
mnemonic - deltoid helps you carry SACS
insertion of deltoid
deltoid tuberosity of humerus
actions of deltoid
abducts shoulder from 20 degrees onwards (can’t initiate abduction)
flexion and extension of shoulder
what nerve innervates deltoid?
axillary nerve
origin of teres major
posterior scapula
insertion of teres major
anterior humerus
action of teres major
medial rotation and adduction of humerus
borders of quadrilateral space
superior - teres minor
inferior - teres major
medial - long head triceps
lateral - surgical neck of humerus
what nerve is found in the quadrilateral space?
axillary nerve
what 2 muscles are innervated by the axillary nerve?
deltoid
teres major
origin of supraspinatus
supraspinous fossa of scapula
insertion of supraspinatus
superior facet of greater tubercle of humerus
origin of infraspinatus
infraspinous fossa of scapula
insertion of infraspinatus
middle facet of greater tubercle of humerus
origin of teres minor
lateral border of scapula
insertion of teres minor
inferior facet of greater tubercle of humerus
origin of subscapularis
subscapular fossa of scapula
insertion of subscapularis
lesser tubercle of humerus
action of supraspinatus
first 20 degrees of abduction at shoulder
action of infraspinatus
lateral rotation at shoulder
action of teres minor
lateral rotation at shoulder
action of subscapularis
medial rotation at shoulder
origins of triceps brachii
long head - infraglenoid tubercle of scapula
lateral head - posterior humerus, above radial groove
medial - posterior humerus, below radial groove
insertion of triceps brachii
olecranon of ulna
action of triceps brachii
long head contributes to shoulder extension
extension at elbow
what nerve innervates triceps brachii
radial nerve
what is a painful arc?
when 60 to 120 degrees abduction is painful
is pathology of supraspinatus tendon
what may be damaged by dislocation of shoulder?
axillary artery
axillary nerve injury
paralysis of deltoid
altered sensation or numbness of upper lateral arm
radial nerve injury
weakness of triceps
so impaired elbow extension
what parts joint at elbow joint?
trochlea of humerus with trochlear notch of ulna
capitellum of humerus with head of radius
anterior border of axilla
pectoralis major and minor
posterior border of axilla
subscapularis, teres major and latissimus dorsi
lateral border of axilla
upper humerus
medial border of axilla
serratus anterior and chest wall
apex of axilla
1st ribs, clavicle, scapula
base of axilla
skin and fascia
contents of axilla
lymph nodes
axillary artery
axillary vein
brachial plexus
what artery is the axillary artery a continuation of?
subclavian
what artery does the axillary artery become and when does this happen?
becomes brachial artery
as crosses teres major
stages of brachial plexus
roots trunks divisions cords branches
axillary nerve roots
C5 and C6
branch of posterior cord
axillary nerve function
motor to deltoid and teres major
sensory to upper lateral arm
radial nerve roots
C5-T1
posterior cord
radial nerve function
motor to triceps and posterior forearm
sensory to arm, forearm and hand
roots of musculocutaneous nerve
C5-C7
musculocutaneous nerve function
motor to anterior arm
sensory to forearm
median nerve roots
C6-T1
median nerve function
motor to anterior forearm and thumb muscles
sensory to lateral palm and digits
ulnar nerve roots
C8-T1
ulnar nerve function
motor to muscles of hand
sensory to median hand and medial digits
muscles of anterior arm
biceps brachii
brachialis
coracobrachialis
nerve for muscles of anterior forearm
musculocutaneous nerve
origins of biceps brachii
long head - supraglenoid tubercle of scapula
short head - coracoid process of scapula
insertion of biceps brachii
radial tuberosity of humerus
actions of biceps brachii
flexor at elbow and shoulder
supinator of forearm when flexed
brachialis origin
anterior lower shaft of humerus
insertion of brachialis
ulnar tuberosity
action of brachialis
flexor at elbow
origin of corachobrachialis
coracoid process of scapular
insertion of corachobrachialis
medial middle humerus
action of corachobrachialis
weak flexor of shoulder
cubital fossa borders
medial - pronator teres
lateral - brachioradialis
superior - line between lateral and medial epicondyles of humerus
contents of cubital fossa
biceps brachii tendon
brachial artery, bifurcates into radial and ulnar arteries
median nerve
radial nerve
which nerve may be injured by fracture to medial epicondyle of humerus?
ulnar nerve
movements possible at distal and proximal radioulnar joints
pronation
supination
movements possible at radiocarpal joint
flexion
extension
adduction
abduction
innervation of muscles in anterior forearm
median nerve
except flexor carpi ulnaris - ulnar nerve
and lateral 1/2 flexor digitorum profundus - median nerve
muscles of anterior forearm
pronator teres flexor carpi radialis palmaris longus flexor carpi ulnaris flexor digitorum superficialis flexor digitorum profundus flexor pollicis longus pronator quadratus
origin of pronator teres
medial epicondyle of humerus
action of pronator teres
pronator of proximal radioulnar joint
origin of flexor carpi radialis
medial epicondyle of humerus
insertion of flexor carpi radialis
radial side of wrist
action of flexor carpi radialis
flexes and abducts wrist
origin of palmaris longus
medial epicondyle of humerus
insertion of palmaris longus
fascia of palm
action of flexor carpi ulnaris
flexion and adduction of wrist
action of flexor digitorum superficialis
flexes digits 2-4
innervation of flexor digitorum profundus
lateral 1/2 median nerve
medial 1/2 ulnar nerve
action of flexor pollicis longus
flexes thumb
action of pronator quadratus
pronates distal radioulnar joint
contents of carpal tunnel
4 tendons FDS
4 tendons FDP
tendon FPL
median nerve
which vein drains lateral forearm?
cephalic
which vein drains medial forearm?
basilic
which veins form axillary vein?
basilic as it receives deep veins of arm
cephalic also joins
what is the most commonly fractured bone of the hand?
scaphoid
what muscles are the prime flexors of the wrist?
flexor carpi radialis
flexor carpi ulnaris
palmaris longus
insertion of flexor digitorum superficialis
tendon splits into two slips which insert on either side of middle phalanx of digits 2-5
action of flexor digitorum superficialis
flexed MCP joints and PIP joints of digits 2-5
insertion of flexor digitorum profundus
palmar aspect of distal phalanx of digits 2-5
action of flexor digitorum profundus
only flexor of DIP joint
flexed PIP and MCP joints of digits 2-5
insertion of flexor pollicis longus
distal phalanx of thumb
action of flexor pollicis longus
flexes IP joint of thumb
muscles of thenar eminence
flexor pollicis brevis
abductor pollicis brevis
opponens pollicis
insertion of flexor pollicis brevis
proximal phalanx of thumb
insertion of abductor pollicis brevis
proximal phalanx of thumb, lateral aspect
insertion of opponens pollicis
1st metacarpal
innervation of thenar muscles
recurrent branch of the median nerve
attachments of adductor pollicis
3rd metacarpal
proximal phalanx of thumb
innervation of adductor pollicis
ulnar nerve
muscles of hypothenar eminence
flexor digiti minimi
abductor digiti minimi
opponens digiti minimi
insertion of flexor digiti minimi
proximal phalanx of digit 5
insertion of abductor digiti minimi
proximal phalanx of digit 5
insertion of opponens digiti minimi
5th metacarpal
innervation of hypothenar muscles
deep branch of ulnar nerve
origin of lumbricals
tendons of flexor digitorum profundus
insertion of lumbricals
dorsal aspect of proximal phalanges of digits 2-5
innervation of lumbricals
lateral two by median nerve
medial two by ulnar nerve
how many interossei are there?
3 palmar interossei
4 dorsal interossei
action of interossei
palmar interossei adduct the fingers
dorsal abduct the fingers
PAD-DAB
also contribute to extension of fingers at IP joints
cutaneous innervation of hand
median nerve - palmar surface of lateral hand, palmar surface 3.5 lateral digits, skin over dorsum of distal phalanges of lateral 3.5 digits
ulnar - palmar and dorsal surfaces of medial side of hand and medial 1.5 digits
radial nerve - dorsal surface of lateral side of hand, skin over dorsum of lateral 3.5 digits up to IP joints
what region of skin is definitely innervation by median nerve?
palmar surface of middle finger
what region of skin is definitely supplied by ulnar nerve?
medial border of hand
what region of skin is definitely supplies by radial nerve?
dorsum of hand, lateral aspect
dermatomes of upper lateral arm
C5
dermatome of thumb
C6
dermatome of middle finger
C7
dermatome of medial border of hand
C8
dermatome of medial border of elbow
T1
which arteries supply the hand?
radial and ulnar
both branches of brachial artery
superficial palmar arch of hand
mostly formed from ulnar artery
smaller contributed from radial artery
deep palmar arch
largely formed by radial artery
smaller contribution from ulnar artery
what do the palmar arches give rise to?
metacarpal and digital arteries that supply palm and digits
innervation of posterior forearm
radial nerve
muscles of posterior forearm
brachioradialis extensor carpi radialis longus extensor carpi radialis brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris
what is the common extensor origin?
lateral epicondyle of humerus
origin of brachioradialis
humerus, proximal to lateral epicondyle
insertion of brachioradialis
distal radius
action of brachiradialis
weak flexor of elbow joint
insertion of extensor carpi radialis longus
2nd metacarpal
insertion of extensor carpi radialis brevis
3rd metacarpal
action of ECRL and ECRB
extend and abduct wrist
action of extensor digitorum
extends the digits
insertion of extensor carpi ulnaris
5th metacarpal
action of extensor digiti minimi
extends little finger
action of extensor carpi ulnaris
extends and adducts wrist
muscles of deep posterior forearm
supinator abductor pollicis longus extensor pollicis brevis extensor pollicis longus extensor indicis
action of supinator
supinates forearm and hand
insertion of abductor pollicis longus
1st metacarpal
insertion of extensor pollicis brevis
proximal phalanx
insertion of extensor pollicis longus
distal phalanx
action of extensor pollicis brevis
extends MCP joint
action of extensor pollicis longus
extends IP joint of thumb
insertion of extensor indicis
dorsum of index finger
action of extensor indicis
independent extension of index finger
what veins does the dorsal venous network of the hand drain into?
cephalic vein laterally
basilic vein medially
insertions of extensor hood
central slip onto middle phalanx
marginal slips onto distal phalanx
anatomical snuffbox boundaries
EPL tendon medially
EPB and APL tendons laterally
floor of anatomical snuffbox
scaphoid
contents of anatomical snuffbox
radial artery
cephalic vein
artery supply to posterior forearm
ulnar artery
what articulates at shoulder joint?
glenoid fossa of scapula and head of humerus
tendon of which muscle contributes to stability of shoulder joint?
long head of biceps
what articulates at elbow joint?
trochlea of humerus with trochlea notch of ulnar
capitellum of humerus and radial head
what joints are present in elbow joint?
medial and lateral collateral ligaments
what ligament holds radial head in place?
anular ligament of the radius
what type of joint is wrist joint?
condyloid
what type of joint is radioulnar joint
pivot
what type of joint is the first metacarpal joint?
saddle joint
between trapezium and 1st metacarpal
what type of joints are MCP joints?
condyloid
what type of joints are interphalangeal joints?
hinge joints
what type of joint is the knee joint?
hinge joint
what type of joint is the ankle joint?
hinge joint
what articulates at ankle joint?
distal ends of tibia and fibula with talus