Upper Limb Flashcards
what is flexion
a movement that decreases the angle between 2 body parts
what is extension
a movement that increases the angle between 2 body parts
what bones make up the pectoral girdle
clavicle and scapula
what bone is in the arm
humerus
what bones make up the forearm
radius and ulna
what is the name of the bones that make up the wrist
carpal bones
what does the clavicle articulate with
acromium process of the scapula laterally
acromioclavicular joint
sternum medially
sternoclavicular joint
3 ligaments of the clavicle and the scapula
acromioclavicular (covers)
conoid(coracoid to conoid tubercle)
trapeziod (coracoid to trapezoid line)
what are the conoid and trapezoid ligaments known. as
coracoclavicular ligament
what are the articulations of the humerus
proximally: scapula - glenohumeral joint
distally: radius and ulna (elbow joint)
what is the name for the shoulder joint
glenohumeral joint
what type of joint is glenohumeral
synovial ball and socket
what are the joint surfaces of the glenohumeral joint
head of humerus and glenoid fossa of scapula
movements of the glenohumeral joint
flexion/extension
abduction/adduction
medial rotation/lateral rotation
circumduction
what 3 things give stability to the glenohumeral joint
rotator cuff muscles (pulls head in)
glenoid labrum (deepens cavity)
ligaments (reinforce capsule)
what are bursae
fluid-filled sac between ligaments and protects from bone, stopping surfaces from rubbing together
neurovascular supply to the glenohumeral joint
arterial: ant and post circumflex arteries and suprascapular arteries
innervation: axillary, suprascapular, lateral pectoral nerves
what kind of joint is the elbow joint
synovial hinge joint
what are the 2 components of the elbow joint
articulation between humerus and ulna @ trochlea
articulation between humerus and radius @ capitulum
what are the ligaments called that support the elbow joint
radial collateral ligament - lat epicondyle and blends with annular ligament
ulnar collateral - med epicondyle yo coronoid process and olecrannon
what are the 2 radioulnar joints
proximal - head of radius and radial notch of ulna - annular ligament
distal - head of ulnar and ulnar notch of the radius - ant and post radioulnar ligaments
name the bones of the wrist
Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate
what is the name for the wrist joint
radiocarpal joint
what type of joint is the radiocarpal joint
condyloid joint
what is the joint between the 2 rows of carpal bones
midcarpal
what type of joint are the medial 4 carpometacarpal joints
plane joints
what type of joint is the carpometacarpal joint of the thumb
saddle joint
what 5 muscles are involved in the movements of the shoulder girdle
Trapezius
Rhomboids
Levator scapulae
Serratus anterior
Pectoralis minor
what are the anterior axioappendicular muscles
Pectoralis major
Pectoralis minor
Serratus anterior
Subclavius
what are the posterior axioappendicular muscles
Trapezius
Lattissimus dorsi
Levator scapulae
Rhomboid major
Rhomboid minor
Deltoid
Rotator cuff group
Teres major
what muscles are in the scapulohumeral group
deltoid, rotator cuff group, teres major
what are the superficial group of the axioappendicular muscles
trapezius
latissimus dorsi
what is the the function of the superfical group of the axioappendicular muscles
connect upper limb to axial skeleton
move scapula
move humerus
attachments of trapezius
occipital bone, nuchal ligament, spinous processes c7-t12
attach to clavicle, acromiom and spine of scapula
nerve supply to trapezius
CN XI spinal accessory nerve
the functions of the 3 fibres in the trapezius
superior fibres-elevate scapula and rotate during abduction
middle fibres-retract scapula
inferior fibres - pull scapula inferiorly
attachments of latissimus dorsi
arises from spinous process of T7-T12, iliac crest, thoracolumbar fascia and ribs 10-12
tendons insert into intertubercular sulcus of the humerus
nerve supply to latissimus dorsi
thoracodorsal nerve
action of latissimus dorsi
extend, adduct and medially rotate upper limb
attachment, innervation and action of levator scapulae
C1-C4 transverse processes -> medial border of scapula
dorsal scapular nerve
elevate scapula
where do you find rhomboids
deep to trapezius and inferior to levator scapulae
fibres run inferolaterally from the vertebrae to medial border of scapulae
attachment, innervation and action of rhomboid major
spinous processes of T2-T5 vertebrae ->medial border of scapula
dorsal scapular nerve
retracts and downward rotate
attachment, innervation and action of rhomboid minor
spinous processes of C7-T1 -> medial border of scapula
dorsal scapular nerve
retract and downward rotate scapula
attachment and action of deltoid muscle
clavicle, acromion process, spine -> deltoid tuberosity of humerus
anterior: flexion and medial rotation
posterior: extend and laterally rotate
middle: abduct arm past 15 degrees
attachment, innervation and action of teres major
inferior aspect of scapula -> intertubercular groove of humerus
lower subscapular nerve
adduction and medial rotation
what 4 muscles make up the rotator cuff
Supraspinatus
Infrapinatus
Subscapularis
Teres minor
attachment, innervation and action of supraspinatus
supraspinous fossa->greater tubercle of humerus
suprascapular nerve
abduct arm first 15 degrees
attachment, innervation and action of infraspinatus
infraspinous fossa -> greater tubercle of humerus
suprascapular nerve
laterally rotate arm
attachment, innervation and action of subscapularis
subscapular fossa -> lesser tubercle of the humerus
upper and lower subscapular nerves
medially rotates arm
attachment, innervation and action of teres minor
posterior scapula-> greater tubercle of humerus
axillary nerve
laterally rotates the arm
muscles of the anterior compartment of the arm
Biceps brachii
Brachialis
Coracobrachialis
muscles of the posterior compartment of the arm
triceps brachii
anconeus
what are the 3 heads of triceps brachii
long-infraglenoid tubercle of scapula
medial - post. surface of humerus, inferior to radial groove
lateral - post surface sup to radial groove
insertion, innervation and action of triceps brachii
insert into olecranon of ulna
radial nerve
extend forearm at elbow
attachment, innervation and action of anconeus
lateral epicondyle of humerus to posterolateral aspect of olecranon
radial nerve
extend forearm @ elbow. stabilising extended joint
what is exits the quadrangular space
neurovascular supply to the scapular region
axillar n, posterior circumflex humeral artery and vein
describe the function of axillary nerve
motor innervation: deltoid and teres minor
cutaneous innervation: regimental patch
innervation to glenohumeral joint
attachment, innervation, blood supply and action of pectoralis major
medial clavicle, sternum, costal cartilages->intertubercular groove of humerus
medial and lateral pectoral nerve
thoracoacromial trunk
clavicular head= flex; 2 heads adduct and medially rotate
attachment, innervation, blood supply and action of pectoralis minor
coracoid process -> ribs 3,4,5
medial pectoral nerve
thoracoacromial trunk
protract and stabilise
what muscles attach on the intertubercular groove
Pectoralis major
Latissimus dorsi
Teres major
attachment, innervation, blood supply and action of serratus anterior
upper 8 ribs -> medial border and inf. angle of scapula
long thoracic nerve
thoracodorsal, lateral and superior thoracic artery
draw scapula forward, rotate scapula
attachment, innervation and action of biceps brachii
long head supraglenoid tubercle;short coracoid -> radial tuberosity and bicipital aponeurosis
musculocutaneous nerve
supinate forearm
attachment, innervation and action of brachialis
medial and lateral aspects of shaft of humerus -> tuberosity of ulna
musculocutaneous nerve
flexor of elbow joint
attachment, innervation and action of coracobrachialis
coracoid process -> medial shaft
musculocutaneous n (pierces musc)
flexes arm @ shoulder joint;weak adductor
Branches of the subclavian artery
Vertebral
Internal thoracic
Thyrocervical trunk
Costocervical trunk
Dosal scapular
describe the axillary artery
supplies walls of axilla and related regions
continuos with subclavian and brachial artery
related to cords of brachial plexus
branches of axillary artery
Superior thoracic
Thoracoacromial
Lateral thoracic
Subscapular
Anterior circumflex humeral
Posterior circumflex humeral
screw the laywer save a patient
describe the brachial artery
continuation of axillary artery
main blood supply for arm
gives the profunda brachii - radial groove of humerus
terminates as bifurcates into radial and ulnar arteries
describe venous drainage from upper limb to heart
superficial: cephalic vein, basilic vein, median cubital
deep: radial veins, ulnar veins, brachial veins
lymphatic drainage of the upper limb
above umbilicus level -> axillary nodes
drain into jugular-subclavian confluence
what is the axilla formed by
clavicle, scapula, thoracic wall, humerus and associated muscles
what makes up the borders of the axilla
Apex: 1st rib, scapula, clavicle
Ant.: pec maj and min, subclavius
Medial: thoracic wall and serratus ant.
Post.: subscapularis, teres major, latissimus dorsi
Lat.: intertubercular groove of the humerus
Floor: skin and fascia
what is the brachial plexus formed by
union of the anterior rami of the last 4 cervical (C5-8) and first thoracic (T1)
describe the musculocutaneous nerve
most lateral
pierces coracobrachialis
supplies BC
cutaneous innervation to skin of forearm
describe the median nerve
runs medially in forearm
innervate some flexor musc of forearm, thenar musc of thumb, lateral lumbricals
cutaneous innervation to lat aspect of palm and 3 1/2 digits on palmar surface
describe the radial nerve
exits via triangular interval
descends in soiral groove of humerus
motor innervation to posterior upper limb
cutaenous innervation to post arm and forearm, and post and lateral dorsum of hand
describe the ulnar nerve
medially in UL
innervates muscle of hand and some flexor of forearm
cut. inn. of ant and post of 1.5 digits and palm
what is wrist drop
inability to extend the wrist and/or digits
what causes wrist drop
damage or injury to the radial N or its branches
midshaft humerus: extension of elbow affected
forearm: elbow extension possible
numbness on forearm post. and hand dorsum
what causes ERB’s palsy & what is it
upper brachial plexus lesion
excessive displacement of head to opposite side/depression of shoulder on same side
what are the muscles in the superficial group of the forearm
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
what are the muscles in the deep group of the forearm
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
what muscle is in the intermediate group of the forearm
flexor digitorum superficialis
attachment, innervation and action of pronator teres
medial epicondyle -> radius
median nerve
pronates
attachment, innervation and action of flexor carpi radialis
medial epicondyle -> 2nd metacarpal
median nerve
flex and abduct
attachment, innervation and action of palmaris longus
medial epicondyle -> flexor retinaculum and palmar aponeurosis
median nerve
flex
attachment, innervation and action of flexor carpi ulnaris
medial epicodyle -> 5th metacarpal
ulnar nerve
flex, adduct
attachment, innervation and action of flexor digitorum superficialis
common flexor tendon,ulna,radius -> middle phalanx of digit 2-5
median n
flex
attachment, innervation and action of flexor digitorum profundus
ulna&interosseous membrane -> distal phalanx of digit 2-5
lateral half= median nerve, medial half by ulnar n
flexion
attachment, innervation and action of flexor pollicis longus
radius and interosseous membrane -> distal phalanx of digit 1
median nerve
flexes wrist and joints of thumb
attachment, innervation and action of pronator quadratus
radius->ulna
median n
pronate forearm
what is the cubital fossa
triangular area on the anterior view of the elbow
bounded by muscles and bone
boundaries of cubital fossa
Sup: imaginary line between epicondyles
Medial: lateral border or pronator teres
Lat: medial border of brachioradialis
Apex: meeting point of lateral and medial boundaries
Roof: bicipital aponeurosis
Floor: brachialis
contents of the cubital fossa
T biceps brachii tendon
A brachial artery
N median nerve
what is the carpal tunnel
narrow passage in the wrist
borders of the carpal tunnel
Deep- carpal arch
Superficial- flexor retinaculum
contents of carpal tunnel
tendons from FDS x 4
tendons from FDP x 4
tendon from FPL
median nerve
what is carpal tunnel syndrome
occurs due to swelling or compression of median n in carpal tunnel
overweight, pregnant, repetitive movements
what are the muscles in the anterior forearm innervated by
median nerve
except FCU and the medial half of FDP
what are the muscles in the hand innervated by
ulnar nerve
except HALF LOAF
HALF Lumbricals
Opponens pollicis
Abductor pollicis
Flexor pollicis brevis
what is indicative of median nerve damage
weak wrist flexion
forearm may be supine
weak or total loss of flexion in MCP and/or IP joints
Hand of benediction when making fist
what is indicative of ulnar nerve damage
weak wrist flexion
loss of flexion of digits 4&5
loss of sensation
loss of thumb adduction
what are the superficial muscles of the posterior compartment of the forearm
Brachoradialis
Extensor carpi radialis longus
ECR brevis
Ext. digitorum
Ext. digiti minimi
Ext. carpi ulnaris
what are the deep muscles of the posterior compartment of the forearm
Abductor pollicis longus
Extensor policis logus
Ext. pollicis brevis
Extensor indices
Supinator
what nerve innervates the posterior compartment of the forearm
radial nerve
attachment, innervation and action of brachioradialis
lat. supracondylar ridge of humerus-> styloid process of distal radius
radial n
flexes forearm at elbow
where do the superficial muscles in the posterior compartment of forearm originate except brachioradialis
lateral epicondyle
what is the function of the superficial muscles in the posterior compartment of the forearm ex. brachioradialis
extend the wrist
where do the deep muscles of the posterior compartment originate
interosseous membrane, ulna or radius
what is the action of the deep muscles of the forearm
extend the wrist (except supinator)
attachment and action of supinator
proximal ulna and lat epicondyle of humerus -> proximal radius
supinate forearm
what are the borders of the anatomical snuffbox
base: styloid process of radius
medial: extensor pollicis longus
lateral: extensor pollicis brevis and APL
floor: scaphoid and trapezium
roof: overlying skin
contents of anatomical snuffbox
radial artery, superficial radial nerve
what gives vascular su0pply to the forearm and hand
brachial artery branches to give radial and ulnar
other branches
anastomose with radial and ulnar to form anastamotic network
describe the ulnar artery in the forearm
runs deep to pronator teres and FCU muscles
in hand, branches to give supply to deep palmar arch and superficial palmar arch
describe the radial artery in the forearm
runs deep to brachioradialis
in hand, branches to give supply to the deep palmar arch and superficial palmar arch
what innervates the dorsum of the hand
the superficial branch of the radial nerve gives innervation to part
