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MRCS Anatomy > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

Where does scapula extend from?

A

Ribs 2-7 when arm by side

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2
Q

Why is rotation of the scapula required

A

For full abduction

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3
Q

Describe osteology of clavicle

A

Medial 2/3 convex anteriorly and circular cross-section
Lateral 1/3 convex posteriorly and flat cross-section

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4
Q

Costoclavicular ligament?

A

Attaches clavicle to 1st costal cartilage

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5
Q

First bone to ossify in foetus?

A

Clavicle - only long bone which develops in a membrane

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6
Q

Function of clavicle?

A

Transmit force from upper limb to axial skeleton
Acts as a strut to hold arm free from trunk

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7
Q

What may pierce the clavicle?

A

Supraclavicular nerves

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8
Q

Most commonly frac bone?

A

Clavicle - usually at junction between middle and lateral 1/3

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9
Q

Describe the humeral head

A

1/3 of a sphere facing upwards and backwards

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10
Q

What separates greater and lesser tubercle of humerus?

A

Bicipital groove - containing long head of biceps tendon

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11
Q

What passes medially and wraps round surgical neck of humerus?

A

Axillary nerve
Posterior circumflex humeral artery and vein

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12
Q

Radial nerve path around humerus?

A

Sits in spiral groove which lies posteriorly on the shaft and winds around - between the medial and lateral heads of triceps

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13
Q

Osteology of distal humerus

A

Rounded capitulum laterally - for articulation with radial head
Trochlea medially - for articulation with trochlear notch of ulna
Medial and lateral epicondyles - these are extracapsular

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14
Q

Where does the ulnar nerve lie relative to the distal humerus?

A

In the groove on the posterior aspect of the medial epicondyle

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15
Q

Osteology of radius and ulna

A

Radius consists of head, neck, radial tuberosity shaft and expanded distal end

Ulna contains olecranon, trochlear fossa, coronoid process with its radial notch for articulation with radial head, shaft and small distal head

Both have a distal styloid process

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16
Q

Carpal bones?

A

Lateral to medial:

Scaphoid lunate triquetral pisiform
Trapezium trapezoid capitate hamate

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17
Q

Shape of carpal bones overall?
How is this shape maintained?

A

Arched transversely with plamar aspect being concave

Maintained by individual bones, which are broader posteriorly than anteriorly

Also by flexor retinaculum passing from scaphoid/trapezium laterally to pisiform and hook of hamate medially

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18
Q

What surface of the triquetrum does pisiform sit on?
What sits next to it distally?

A

Palmar surface

Hook of hamate

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19
Q

Shoulder flexors? (3)

A

Anterior delt
Pec major
Coracobrachialis

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20
Q

Shoulder extensors? (3)

A

Lat dorsi
Teres major
Posterior delt

21
Q

Internal rotators of shoulder? (4)

A

Pec major
Lat dorsi
Subscapularis
Anterior delt

22
Q

External rotators of shoulder? (3)

A

Infraspinatus
Teres minor
Posterior delt

23
Q

Articular surfaces of sternoclavicular joint?
Ligament? Function?

A

Medial end of clavicle and manubrium of sternum with an intra-articular disc

Costoclavicuar cartilage - attaches medial clavicle to first costal cartilage
Acts as a fulcrum so when lateral clavicle is raised (e.g. shrugging), medial is depressed

24
Q

Articular surfaces of ACJ?
Nearby ligaments?
How is movement induced?

A

Lateral clavicle with acromion process - has an incomplete articular disc, surrounded by capsule

Coracoclavicular ( lateral clavicle *coracoid process - conoid is more medial than trapezoid ligament)

Passively with scapular movement

25
Q

Which aspect of glenohumeral joint is not covered by rotator cuff?

A

Inferior

26
Q

Insertion of rotator cuff tendons?

A

Supra/Infra-spinatus and teres minor to greater tuberosity of humerus

Subscapularis to lesser tuberosity

27
Q

Path of supraspinatus?

A

Passes over apex of shoulder, beneath acromion and coracoacromial ligament, from which it is separated by the subacromial bursa, then to greater tuberosity

28
Q

Relationship between joints in the shoulder girdle and shoulder movement?

A

All but very slight glenohumeral movements are always accompanied by movements of the scapula on the clavicle and clavicle on manubrium.

29
Q

Muscles involved in full abduction?

A

Supraspinatus initiates to 15 degrees
Deltoid takes over to 90 degrees
90-180 degrees is by rotation of the scapula by trapezius and serratus anterior

30
Q

Relationship between glenohumeral, scapular and sternoclavicular movements?

A

As soon as abduction commences rotation of scapula begins

Movements of scapula occur with reciprocal movements of sternoclavicular joint eg elevate the shoulder and sternoclavicular joint is depressed - move shoulder forwards and the joint moves backwards

31
Q

What muscles elevate the shoulder?

A

Trapezius and elevator scapulae

32
Q

What depresses the shoulder?

A

Gravity, pec major and pec munor

33
Q

What protracts the scapula?

A

Serratus anterior and pec minor

34
Q

What retracts the scapula?

A

Rhomboids and middle fibres of trapezius

35
Q

What muscles rotate the scapula?

A

Trapezius and serratus anterior

36
Q

How will fragments of clavicle move in a fracture?

A

Trapezius unable to support weight of arm
Lateral fragment is depressed down and drawn medially by shoulder adductors and broken ends overlap.
Slight elevation of medial fragment due to sternocleidomastoid

37
Q

How can someone adduct arm in supraspinatus tendon rupture?

A

Tilt body to injured side so gravity pulls limb away from trunk and deltoid activates

38
Q

Which nerve supplies the serratus anterior?
Roots?
How is it commonly damaged?

A

Long thoracic nerve

C5-7

Neck, breast or axillary surgery ( = winging of scapula)

39
Q

Describe articulations of elbow joint

A

3 articulations within 1 synovial cavity

Humeroulnar - trochlea of humerus and trochlear notch of ulna (hinge joint)

Humeroradial - capitulum and radial head (ball and socket joint)

Proximal radioulnar - head of radius and radial notch of ulna (pivot joint)

40
Q

Describe structure of elbow joint capsule
What structures are extracapsular?

A

Thin and lax anteriorly and posteriorly

Thickened at sides to form medial and lateral collateral ligaments

Lateral ligament is attached to annular ligament, which holds the radial head in place

Medial and lateral epicondyles are extra capsular

41
Q

Elbow flexors?

A

Biceps, brachial, brachioradialis, forearm flexors

42
Q

Elbow extenders?

A

Triceps
Aconeus

43
Q

Elbow pronators

A

Pronator teres
Pronator quadratus

44
Q

Elbow supinators

A

Biceps
Supinator

45
Q

What are the articular surfaces of the wrist?

A

Distal radius and head of ulna
Proximal scaphoid, lunate, triquetral

Head of ulna separated from carpus by articular disc

46
Q

What type of joint is wrist?

A

Condyloid joint
Allows flexion, extension, abduction and adduction

47
Q

Wrist adductors?

A

Flexor carpi ulnaris
Extensor carpi ulnaris

48
Q

Wrist abductors?

A

Flexor carpi radialis
Extensor carpi radialis longus
Extensor pollicis longus
Abductor pollicis longus

49
Q

What type of joint is thumb CMC?

A

Saddle joint

Allows flexion, extension, abduction, adduction and opposition

Other CMC joints have only limited gliding movement

MRCS Anatomy (1 decks)

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