UPPER LIMB Flashcards
pec major
origin: ant surface of medial half clavicle
ant surf,lat part of sternum
2-6 costal cartilages
aponeurosis of external oblique
insertion: lateral lip of bicipital groove
nerve:medial and lateral pectoral nerve
action:adduction, medial rotation, flexion ( at shoulder joint)
pec minor
origin:3,4,5 ribs
insertion: medial margion,superior surface of coracoid process
nerve: medial(pierces) and lateral pectoral nerve
action:protraction of scapula with serratus ant
depresses shoulder
subclavius
origin:junction of first rib and costal cartilage
insertion:inferior surface of the middle third of clavicle
nerve: subclavius nerve
action:steadies clavicle during shoulder joint movement
serratus anterior
origin:8 fleshy digitations from outer surfaces of upper 8 ribs
insertion:medial border of scapula
nerve:long thoracic nerve
action:protraction of scapula(punching)
Clinical Aspect:
Paralysis of the serratus anterior muscle after an injury to the long thoracic nerve, or during removal of the breast tumor leads to:
1. Weakened protraction of the scapula
2. Winging of the scapula. Inferior angle and medial border become prominent when pushing hands against wall.
clavipectoral fascia*
enclose:
superiorly: subclavius
inferiorly: pec.minor and cont as suspensory ligament of axilla
medially;1st rib
laterally: coracoid process
pierced by: CALL
cephalic vein
acromiothoracic vessel(thoraco-acromial)
lymphatics to apical nodes
lat.pec nerve
polands syndrome
hypoplasia of chest wall muscles
ipsilateral hypoplasia of arm and hand
clinical:
sternocostal head of pec major and pec minor absent
may have absence of nipple areolar complex
trapezius
nerve: ventral rami c3,c4
action:
upper fibers:elevates scapula
middle fibers:retract scapula
upper+lower+ serratus ant:rotatae scapula for overhead abduction at shoulder joint
latissimus dorsi
nerve: posterior cord brachial.p
action:extension,medial rotation at glenohumoral joint
adduction and climbing at shoulder joint
rhomboideus minor and major
nerve: c5
action: retract scapula
levator scapulae
Scapulothoracic joint: Draws scapula superomedially, rotates glenoid cavity inferiorly;
Cervical joints: Lateral flexion of neck (ipsilateral), extension of the neck
nerve:ventral rami of the nerves C3 and C4, dorsal scapular nerve
supraspinatus
origin: medial 2/3 of supraspinous fossa
insertion:upper psrt of greater tubercle of humerus
nerve: suprascapular nerve
action:initiates abduction at shoulder joint(15 degrees)
infraspinatus
origin: medial2/3 infraspinatus fossa
insertion: middle part of greater tubercle
nerve: suprascapular nerve
action:lateral rotation at shoulder joint
teres minor
origin: upper 2/3 lateral border scapula
insertion: lowest part of greater tubercle
nerve: axillary nerve
action: lateral rotation at shoulder joint
teres major
origin: lower 1/3 of lateral border scapula
insertion: medial lip of bicipital groove
nerve: lower subscapular nerve
action:medial rotation and adduction at shoulder joint
subscapularis
origin: medial 2/3 of subscapular fossa
insertion: lesser tubercle
nerve: upper and lower subscapular nerves
action:medial rotation and adduction at shoulder joint
rotator cuff muscles (SITS)
supraspinatus
infraspinatus
teres minor
subscapularis
deltoid
origin:
ant fibers: anterior border,lateral 1/3 clavicle
middle fibers: lat margion acromion process
post.fibers: lower lip of crest of spine (scapula)
insertion: V shape deltoid tuberosity on humerus
nerve: axillary nerve
action:
ant: flexion and medial rotation
middle:abduct arm(15-90)
post: extension and lateral rotation
quadrangular space
above: teres minor
below:teers major
medial:long head tricepss
lateral: surgical. neck humerus
passing through:axillary nerve, posterior circumflex humeral vessels
upper triangular space
above: teres minor
below:teres major
lateral:long head triceps
passing through: circumflex scapular artery
lower triangular space
above:teres major
medial: long head triceps
lateral:humerus shaft
passing through: radial nerve,profunda brachii vessels
gently pricking on skin over deltoid to test?
fracture of surgical neck-> axillary nerve injury-> loss of abduction-> sensory loss over deltoid muscle (upper lateral cutaneous nerve)
biceps brachii
origin:
short head:tip of coracoid process
long head:supraglenoid tubercle
insertion: form bicipital aponeurosis and insert at radial tuberosity
nerve: musculocutaneous n
action: strong supinator when forearm is flexed,flex at elbow joint, short head flex arm
corachobrachialis
origin: tip of coracoid process
insertion:middle mrdial surface humerus
nerve: musculocutaneous nerve
action:weak flexor of arm
brachialis
origin:lower part of humerus shaft
insertion:coronoid process and ulnar tuberosity
nerve: musculocutaneous nerve and radial nerve on the lateral part
action: weak flexion of forearm
brachial artery
beginning: from axillary artery
extent: lower border teres major- neck of radius
termination: divide into radial and ulnar arteries
triceps brachii
origin:
long head:infraglenoid tubercle
medial head:posterior syrface humerus below radial groove
lateral head:lateral lip of radial groove
insertion:posterior,superior surface olecranon process
nerve:radial nerve
action: powerful extensor
anterior compart forearm
superficial-PFPFF
deep-FFP
palmaris longus
flexor carpi radialis
pronator teres
flexor carpi ulnaris
flexor digitorum superficialis
flexor digitorum profundus
flexor pollices longus
pronator quadratus
posterior compart
superficial- ABE5
deep- SAE3
anconeus
brachioradialis
ext.carpi radialis longus
ext.carpi radialis brevis
ext.carpi ulnaris
ext.digitorum
ext.digiti minimi
supinator
abductor pollicis longus
ext.pollicis longus
ext.pollicis brevis
extensor indicis
Flexion
Anterior fibres of deltoid
clavicular fibres of pectoralis major
Extension
Posterior fibres of deltoid
teres major
Medial Rotation
Anterior fibres of deltoid
Pectoralis Major
Teres Major
Subscapularis
Latissimus dorsi
Lateral Rotation
Posterior fibres of deltoid
Infraspinatus
Teres minor
Abduction
Supraspinatus muscle abducts up to 15C
Middle fibres of deltoid abduct up to 90C to 120C
Overhead abduction
Upper and lower fibres of trapezius
Serratus anterior muscle
what is the cutaneous nerve supply for the pectoral region?
- supraclavicular nerve(c3,c4)- divides into medial,intermediate,lateral branches.supply just inferior to clavicle
- ant and lat cute branches from 2-6 intercostal nerves
deltopectoral groove
intermuscular groove between the deltoid and pectoralis major.
- transversed by cephalic vein and delto-pectoral grp of lymph nodes
- deltoid branch of thoracoacromio artery
What are the arteries taking part in scapular anastomosis
Connecting, the certain subclavian artery and their corresponding axillary artery forming circulatory anastomosis around the scapula. It allows for blood to flow past the joint in case of occlusion, damage, or pinching.
