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Musculoskeletal I > Upper limb > Flashcards

Upper limb Flashcards

1
Q

What classification of joint is the sternoclavicular joint?

A

Saddle

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2
Q

What classification of joint is the acromioclavicular joint?

A

Plane

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3
Q

What are the carpals?

A

Capitate
Hamate
Lunate
Pisiform
Scaphoid
Trapezoid
Triquetrum
Trapezium

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4
Q

What are the common ways for a clavicle fracture to occur?

A

Force through outstretched hand from a fall
Fall directly on shoulder

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5
Q

What does the medial fragment of clavicle elevate after fracture?

A

It is elevated by the sternocleidomastoid

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6
Q

What can be damaged by a fracture of the surgical neck of the humerus?

A

Axillary nerve
Posterior circumflex artery

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7
Q

What can be damaged by a fracture of the shaft of the humerus?

A

Radial nerve
Profunda brachii artery

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8
Q

What can be damaged by a fracture of the supracondylar of the humerus?

A

Median nerve
Brachial artery

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9
Q

What can be damaged by a fracture of the medial epicondyle of the humerus?

A

Ulnar nerve
Ulnar collateral artery

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10
Q

What can occur with a lunate dislocation?

A

Compression of median nerve leading to CTS

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11
Q

What is a Boxer’s fracture?

A

Fracture at the head of the 5th metacarpal

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12
Q

What can occur with a hook of hamate fracture?

A

Damage to deep branch of ulnar nerve, in the Guyan’s canal

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13
Q

What can occur from a scaphoid fracture?

A

Avascular necrosis of proximal fragment and lead to DJD of wrist

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14
Q

What are the superficial veins of the upper limb?

A

Cephalic vein
Basilic vein
Median cubital vein

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15
Q

What are the deep veins of the upper limb?

A

Axillary vein into subclavian vein

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16
Q

What is the innervation of pectoralis major?

A

Lateral pectoral (C5-C7) and medial pectoral (C8-T1)

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17
Q

What are the actions of pectoralis major?

A

Flexion, adduction, and medial rotation of arm at shoulder

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18
Q

What is the innervation of pectoralis minor?

A

Medial pectoral (C8-T1)

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19
Q

What are the actions of pectoralis minor?

A

Stabilizes scapula by drawing inferiorly and anteriorly against the thoracic wall

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20
Q

What is the innervation of serratus anterior?

A

Long thoracic (C5-C7)

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21
Q

What are the actions of serratus anterior?

A

Protracts scapula and holds against thoracic wall
Rotates scapula

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22
Q

What is the innervation of subclavius?

A

Nerve to subclavius (C5-C6)

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23
Q

What are the actions of subclavius?

A

Depresses and anchors clavicle

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24
Q

What causes winged scapula?

A

Paralysis of serratus anterior - injury to long thoracic nerve (C5-C7)

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25
Q

What is the innervation of the trapezius?

A

Spinal accessory nerve (CNXI motor)
C3-C4 sensory nerves

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26
Q

What are the actions of the trapezius?

A

Elevation, depression, and retraction of scapula
Rotate glenoid cavity supperiorly

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27
Q

What is the innervation of latissimus dorsi?

A

Thoracodorsal nerve (C6-C8)

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28
Q

What are the action of latissimus dorsi?

A

Extension, adductions, and medial rotation of shoulder joint
Raises body towards arms when climbing

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29
Q

What is the innervation of levator scapulae?

A

Dorsal scapular (C5)
C3 and C4 spinal nerves

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30
Q

What are the actions of levator scapulae?

A

Elevation of scapula and rotates glenoid cavity inferiorly

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31
Q

What is the innervation of rhomboid major and rhomboid minor?

A

Dorsal scapular (C4-C5)

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32
Q

What are the actions of rhomboid major and rhomboid minor?

A

Retraction of scapula and inferior rotation of glenoid cavity
Attaches scapula to thoracic wall

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33
Q

What is the innervation of deltoid?

A

Axillary nerve (C5-C6)

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34
Q

What are the actions of deltoid?

A

Flexion, medial rotation, abduction, extension, and lateral rotation of arm

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35
Q

What are the rotator cuff muscles?

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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36
Q

What is the innervation of supraspinatus?

A

Suprascapular nerve (C5-C6)

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37
Q

What is the action of supraspinatus?

A

Initiate abduction

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38
Q

What is the innervation of infraspinatus?

A

Suprascapular nerve (C5-C6)

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39
Q

What are the actions of infraspinatus?

A

Lateral rotation of arm at shoulder
Hold humeral head in glenoid cavity

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40
Q

What is the innervation of teres minor?

A

Axillary nerve (C5-C6)

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41
Q

What are the actions of teres minor?

A

Lateral rotation of arm at shoulder
Hold humeral head in glenoid cavity

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42
Q

What is the innervation of subscapularis?

A

Upper and lower subscapular nerves (C5-C6)

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43
Q

What are the actions of subscapularis?

A

Medial rotation and adduction of arm
Holds humeral head in glenoid cavity

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44
Q

What is the innervation of teres major?

A

Lower subscapular nerve (C5-C6)

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45
Q

What are the actions of teres major?

A

Adduction and medial rotation of arm

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46
Q

What are the muscles and innervation of the anterior compartment of arm?

A

Biceps brachii
Brachialis
Coracobrachialis

Musculocutaneous nerve

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47
Q

What are the muscle and innervation of the posterior compartment of arm?

A

Triceps brachii
Anconeous

Radial nerve

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48
Q

What are the actions of biceps?

A

Supination and flexion of forearm
Flexion at should joint
Resistance of shoulder dislocation

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49
Q

What are the actions of coracobrachialis?

A

Flexion and adduction at shoulder, resists dislocation

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50
Q

What are the actions of brachialis?

A

Flexion of elbow

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51
Q

What are the actions of triceps?

A

Extension of elbow
Extension of shoulder and resists dislocation

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52
Q

What are the actions of anconeus?

A

Extension of elbow
Stabilizes elbow
Pronation

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53
Q

What are the bursae of the shoulder?

A

Subacromial
Subdeltoid
Subscapular

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54
Q

What is the typical presentation of shoulder dislocation?

A

Head of humerus moved anteriorly and inferiorly
May injure axillary and radial nerve

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55
Q

What is the presentation of AC joint dislocation?

A

Shoulder drops inferiorly with arm held close to body

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56
Q

What is the sign of adhesive capsulitis?

A

Limited ROM to 45 degrees elevation and rotation

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57
Q

What forms the base of the axilla?

A

Axillary fascia and skin

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58
Q

What forms the apex/inlet of the axilla?

A

Passageway for structures - bound by first rib, clavicle, and superior part of scapula

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59
Q

What forms the anterior wall of the axilla?

A

Pec major and minor, and clavipectoral fascia

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60
Q

What forms the posterior wall of the axilla?

A

Subscapularis, teres major, latissimus dorsi, and long head of triceps

61
Q

What forms the medial wall of the axilla?

A

Upper rib cage, intercostal muscles, and serratus anterior muscles

62
Q

What forms the lateral wall of the axilla?

A

Humerus

63
Q

What is in the axilla?

A

Axillary veins
Axillary artery
Axillary lymph nodes
Brachial plexus
Axillary tail in females
Biceps and coracobrachialis

64
Q

What are the axillary fasciae?

A

Pectoral fascia
Clavipectoral fascia
Axillary fascia
Axillary sheath

65
Q

What are the 5 groups of axillary lymph nodes?

A

Central
Lateral/brachial/humeral
Posterior/subscapular
Anterior/pectoral
Apical/subclavian

66
Q

What drainage do lateral lymph nodes receive?

A

Most of upper limb

67
Q

What drainage do posterior lymph nodes receive?

A

Upper back, neck, and shoulder

68
Q

What drainage do anterior lymph nodes receive?

A

Breast and anterior trunk

69
Q

What drainage do apical lymph nodes receive?

A

Connect with infraclavicular nodes

70
Q

What drainage do central lymph nodes receive?

A

Lymph from other node groups

71
Q

How can you compress the axillary artery?

A

Apply downward pressure at angle between clavicle and attachment of sternocleidomastoid

72
Q

What nerves branch from the roots of the brachial plexus?

A

Long thoracic
Dorsal scapular

73
Q

What nerves branch from the upper trunk of the brachial plexus?

A

Nerve to subclavius
Suprascapular

74
Q

What nerves branch from the medial cord of the brachial plexus?

A

Medial pectoral
Medial root of median nerve
Medial cutaneous of arm
Ulnar nerve
Medial cutaneous of forearm

75
Q

What nerves branch form the lateral cord of the brachial plexus?

A

Lateral pectoral
Lateral root of median nerve
Musculocutaneous

76
Q

What nerves branch from the posterior cord?

A

Upper subscapular
Lower subscapular
Thoracodorsal
Radial
Axillary

77
Q

What is innervated by the musculocutaneous nerve?

A

Anterior arm

78
Q

What is innervated by the axillary nerve?

A

Shoulder

79
Q

What is innervated by the radial nerve?

A

Posterior arm and forearm

80
Q

What is innervated by the median nerve?

A

Anterior forearm and lateral hand

81
Q

What is innervated by the ulnar nerve?

A

Anterior forearm and medial hand

82
Q

What nerves are damaged if arm is medially rotated and adducted?

A

Axillary and suprascapular

83
Q

What nerve is damaged if forearm is extended and pronated?

A

Musculocutaneous

84
Q

What is damaged if limb hands by side and is tightly adducted at shoulder?

A

Rotator cuff muscles or their innervation

85
Q

What occurs with a lower brachial plexus lesion?

A

Damage to ulnar and median nerves

86
Q

What are the intermuscular spaces of the shoulder?

A

Quadrangular
Upper triangular
Lower triangular

87
Q

What is contained in the quadrangular space?

A

Axillary nerve
Posterior circumflex humeral artery

88
Q

What is contained in the upper triangular space of the arm?

A

Circumflex scapular artery

89
Q

What is contained in the lower triangular space?

A

Radial nerve
Deep brachial artery

90
Q

What can damage the axillary nerve?

A

Fracture of cervical neck of humerus
Inferior dislocation of shoulder

91
Q

What nerve innervates the sensation of the shoulder?

A

Axillary

92
Q

What are signs of a damaged axillary nerve?

A

Loss of abduction at shoulder
Weak lateral rotation
Sensory loss of shoulder and lateral arm

93
Q

What nerve innervates sensation of lateral forearm?

A

Musculocutaneous

94
Q

What can damage the musculocutaneous nerve?

A

Compression at coracobrachialis
Trauma to axilla

95
Q

What are the clinical signs of a damaged musculocutaneous nerve?

A

Weakness of elbow flexion
Reduced/absent biceps reflex
Weakness of supination
Sensory loss of lateral forearm

96
Q

What nerve is damaged with a midshaft fracture of the humerus?

A

Radial nerve

97
Q

What nerve runs through the medial epicondyle of the humerus?

A

Ulnar

98
Q

What artery branches off the first part of the axillary artery?

A

Superior thoracic

99
Q

What arteries branch off the second part of the axillary artery?

A

Thoraco-acromial
Lateral thoracic

100
Q

What arteries branch off the third part of the axillary artery?

A

Circumflex humeral arteries
Subscapular

101
Q

What arteries branch off subscapular artery?

A

Circumflex scapular
Thoracodorsal
Axillary

102
Q

What does the axillary artery become?

A

Brachial artery

103
Q

What arterial anastomoses can occur around the scapula?

A

Dorsal scapular, suprascapular, and subscapular

104
Q

What are the bursae of the elbow?

A

Intratendinous olecranon bursa
Subtendinous olecranon bursa
Subcutaneous olecranon bursa

105
Q

What are 4 main arteries that flow through the elbow joint?

A

Radial artery
Posterior interosseous artery
Ulnar artery
Common interosseous artery

106
Q

What can be damaged by an evulsion fracture of the medial epicondyle of the humerus?

A

Ulnar nerve

107
Q

What may be damaged by a posterior elbow dislocation?

A

Ulnar nerve or median nerve

108
Q

What are the movements of the wrist?

A

Flexion, extension, abduction, and adduction

109
Q

What is contained in the cubital fossa?

A

Biceps tendon
Median nerve
Superficial and deep radial nerves
Brachial artery and branches
Deep veins

110
Q

What forms the roof of the cubital fossa?

A

Fascia
Bicipital aponeurosis
Median cubital vein
Medial and lateral cutaneous nerves of forearm

111
Q

What are the superficial muscles of the anterior forearm?

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
flexor digitorum superficialis

112
Q

What muscles are innervated by the median nerve in the anterior forearm?

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor digitorum superficialis
Lateral flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

113
Q

What are the deep muscles of the anterior forearm?

A

Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus

114
Q

What muscles are innervated by the ulnar nerve in the anterior forearm?

A

Flexor carpi ulnaris
Medial flexor digitorum profundus

115
Q

What are the muscles of the posterior forearm?

A

Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor carpi ulnaris
Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis

116
Q

What nerve innervates the posterior forearm?

A

Radial

117
Q

What are the 3 deep fasciae of the hand?

A

Flexor retinaculum
Palmar aponeurosis
Fibrous flexor sheath of digits

118
Q

What muscles are in the palm of the hands?

A

Dorsal interosseous
Palmar interosseous
Lumbrical

119
Q

What muscles are in the thenar prominence?

A

Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Adductor pollicis

120
Q

What muscles are in the hypothenar prominence?

A

Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi

121
Q

What muscles of the hand are innervated by the median nerve?

A

Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Lumbricals 1 and 2

122
Q

What muscles of the hand are innervated by the ulnar nerve?

A

Adductor pollicis
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Lumbricals 3 and 4
Dorsal interossei
Palmar interossei

123
Q

What is affected in Dupuytren contracture?

A

Palmar fascia

124
Q

What structures pass superficially through the carpal tunnel?

A

Palmaris longus tendon
Palmar cutaneous branch of median and ulnar nerves
Superficial branch of radial and ulnar arteries
Ulnar nerve

125
Q

What structures pass deep through the carpal tunnel?

A

Median nerve
Four tendons of FDS
Four tendons of FDP
Flexor pollicis longus tendon
Flexor carpi radialis tendon

126
Q

What nerve is typically compressed in CTS?

A

Median nerve

127
Q

What are the common lesion sites of the median nerve?

A

Proximal to elbow
Distal at wrist

128
Q

What is affected by a median nerve lesion at the elbow?

A

Loss of motor and sensory function of median nerve in forearm and hand resulting in ape hand and benedict hand

129
Q

What can cause a median nerve lesion at the elbow?

A

Fracture of distal humerus
Nerve compression in cubital fossa

130
Q

What would atrophy of thenar eminence indicate?

A

Damage to median nerve at wrist

131
Q

What are common lesion sites of the ulnar nerve?

A

Axilla
Medial epicondyle trauma at elbow
Ventral wrist laceration
Guyon canal compression
Fracture of hook of hamate

132
Q

What is the sign of ulnar nerve injury?

A

Claw hand - weak extension of digits
Abducted thumb

133
Q

What structures run along the shaft of the humerus?

A

Radial nerve
Profunda brachii artery

134
Q

What sensation is innervated by the radial nerve?

A

Dorsal surfaces of arm, forearm, and radial side of hand

135
Q

What can cause a radial nerve injury in the axilla?

A

Long-term compression
Saturday night palsy

136
Q

What nerve is damaged in wrist drop?

A

Radial nerve

137
Q

What can cause radial nerve injury in the arm and forearm?

A

Fracture in midshaft of humerus
Trauma of lateral epicondyle of elbow
Dislocation of head of radius
Compression by supinator

138
Q

What innervates the sensation of the shoulder?

A

Supraclavicular nerve

139
Q

What innervates the sensation of the lateral upper arm?

A

Superior lateral cutaneous nerve of arm

140
Q

What innervates the sensation of the axilla and posterior arm?

A

Intercostobrachial nerve

141
Q

What innervates the sensation of the medial arm?

A

Medial cutaneous nerve of arm

142
Q

What innervates the sensation of the medial forearm?

A

Medial cutaneous nerve of forearm

143
Q

What innervates the sensation of the lateral forearm?

A

Lateral cutaneous nerve of forearm

144
Q

What innervates the sensation of the lateral dorsal hand?

A

Radial nerve

145
Q

What innervates the sensation of the medial hand?

A

Ulnar nerve

146
Q

What innervates the sensation of the lateral palmar hand and lateral fingertips?

A

Median nerve

147
Q

What are the main branches of the brachial artery?

A

Profunda brachii artery
Superior ulnar collateral
Inferior ulnar collateral
Radial
Ulnar

148
Q

What are the main branches of the radial artery?

A

Radial recurrent branch
Palmar carpal branch
Superficial palmar branch
Princeps pollicis
Radialis indicis
Deep palmar arch

149
Q

What are the main branches of the ulnar artery?

A

Anterior ulnar recurrent
Posterior ulnar recurrent
Common interosseous
Palmar carpal branch

Musculoskeletal I (14 decks)

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