Upper Limb Flashcards

1
Q

Where do the nerve roots of the brachial plexus originate from?

A

Anterior rami
C5, C6 C7 C8 T1

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2
Q

The nerves of the brachial plexus leave the anterior rami and pass through the _______

A

Intervertebral foramina

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3
Q

What muscles does the original nerve roots of the brachial plexus pass through?

A

Anterior and medial scalene muscle

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4
Q

The lateral cord of the brachial plexus leads to what 3 nerves?

A

Musculocutaneous
Median

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5
Q

The median nerve is made up of what cords?

A

Lateral, Medial

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6
Q

The median nerve is made up of what trunks?

A

Superior, Middle and Inferior

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7
Q

The posterior cord of the brachial plexus becomes __________

A

Axillary
Radial

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8
Q

What are the five main branches of the brachial plexus?

A

Axillary
Ulnar
Radial
Median
Musculocutaneous

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9
Q

What roots create the ulnar nerve

A

C8 T1

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10
Q

What muscles are supplied by the ulnar nerve?

A

Muscles of the hand
Flexor carpi ulnaris
Flexor digitorum
Medial 2 lumbricals

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11
Q

What nerve of the brachial plexus is the most medial?

A

Ulnar

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12
Q

What are the root origins of the musculocutaneois nerve?

A

C5 C6 C7

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13
Q

What muscles does the musculocutaneous nerve innervate?

A

Biceps Brachii
Coracobrachialis
Brachialis

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14
Q

What are the nerve root origins of the axillary nerve?

A

C5 C6

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15
Q

Where would a sensory deficit be felt in axillary nerve injury?

A

Regimental badge area

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16
Q

What muscles are innervated by the axillary nerve?

A

Deltoid
Teres minor

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17
Q

What are the nerve root origins of the median nerve?

A

C6 C7 C8 T1

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18
Q

What nuscles are innervated by the median nerve?

A

Most flexor muscles (not the flexor carpi ulnaris)
Lateral lumbricals
Thenar muscles

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19
Q

Where is sensory innervation of the median nerve?

A

Lateral palm
1st 2nd 3rd and quarter of 4th finger

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20
Q

What muscles are innervated by the radial nerve?

A

Triceps brachii
Posterior compartment of the forearm (i.e the extensors muscles)

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21
Q

What nerve roots make up the radial nerve?

A

C5 C6 C7 C8 T1

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22
Q

What nerve passes along the groove of the posterior aspect of the medial epicondyle?

A

UInar Nerve

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23
Q

What compartment is impacted in De Quervian’s Tenosynocitis?

A

1st compartment

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24
Q

What are the miscles of the 1st compartment

A

Abductor pollicus longus
Extensor pollicus brevis

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25
Q

Waht are the 3 attachments on the humerus greater tuberosity?

A

Supraspinatus
Infraspinatus
Teres minor

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26
Q

what rotator cuff muscle attaches to the lesser tuberosity of the humerus?

A

Subscapularis

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27
Q

What muscles attach to the intertubular sulcus of the humerus?

A

LAttisimus dorsi
Pectoralis major
Teres minor

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28
Q

What clinical sign will be seen on the humeral surgical neck fracture?

A

Unable to abduct

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29
Q

What nerve is injured in humeral surgical neck fracture?

A

Axillary

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30
Q

Where does the axillary nerve pass through?

A

The quadrangular space

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31
Q

What passes through the clavipectoral triangle?

A

The cephalic vein enters
Medial and lateral pectoral nerves leave

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32
Q

What vessel can be damaged in a supracondular fracture?

A

Brachial artery

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33
Q

What muscles attaches to the humerus shaft and where does it attach?

A

Deltoid
To the deltoid tuberosity

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34
Q

What nerve will be damaged in a mid humeral shaft fracture

A

Radial nerve

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35
Q

What are the clinical signs seen in humeral shaft fracture?

A

Wrist drop
Sensory loss to posterior 1-3 lateral fingers

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36
Q

What vessel is at risk of damage in a humeral shaft fracture/

A

The profunda brachii aka the deep brachial artery

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37
Q

What causes Volkman’s ischaemic contracture?

A

Damage to brachial artery (supracondylar fracutere)

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38
Q

What does Volkmann’s ischaemia contracture look like?

A

Uncontrolled flexion of the hand

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39
Q

How to test for Volkman’s contracture?

A

Ok sign - shows weakness of pollicus longus

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40
Q

What is the branch of the median nerve called?

A

The anterior interosseus nerve

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41
Q

What classification is used to describe supracondular fractures?

A

Gartland Classification

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42
Q

Where does the triceps brachiii attach?

A

Ulna bone - at the olecrannon

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43
Q

Where is the radial notch on the ulna?

A

LAteral surface

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44
Q

What muscle attaches to the ulnar tuberosity?

A

Brachiallis

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45
Q

What the the fracture pattern of a Monteggia’s fracture?

A

Fractured proximal shaft of ulna
Proximal radial head dislocation

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46
Q

What the the fracture pattern of a Galaezzi’s fracture?

A

Fractured distal radius
Dislocation of the ulnar head

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47
Q

What muscle attaches to the anterior shaft of the ulna?

A

Pronator Quadratus

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48
Q

What forms the roof of the ulnar tunnel?

A

Arcuate ligament

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49
Q

What movement elicits difficulty in cubital tunnel syndrome?

A

Elbow flexion

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50
Q

Where would the brachial artery be plapated?

A

Medial to the biceps tendon

51
Q

What muscles are contained in the carpal tunnel?

A

Flexor pollicus longus
4x flexor digitorum profundus
4x flexor digitorum superficialis

52
Q

List the components of the cubital fossa from lateral to medial?

A

Radial nerve
Biceps tendon
Brachial artery
Median nerve

53
Q

What does the medial cubital vein become?

A

Basilic and cephalic veins

54
Q

What compartment is the extensor pollicus longus contained in

A

3rd

55
Q

What nerve is most at risk in a clavicle fracture?

A

Supraclavicular

56
Q

In a clavicular fracture, what direction is the clavicle displaced?

A

Anterior

57
Q

What muscle is responsible for displacing clavicle in a fracture

A

Sternocleidomastoid

58
Q

Where does the biceps brachii insert?

A

Radial tuberosity

59
Q

What muscle inserts into the shaft of the radius?

A

The pronator teres

60
Q

Where is teh styloid provess?

A

Lateral head of distal radius

61
Q

What fracture causes a “dinner fork” anomaly?

A

Colles

62
Q

What is the fracture pattern of a colles fracture?

A

Posterior displacement of hand and wrist
Fracture of distal radius

63
Q

What is the fracture pattern of a Smith’s fracture?

A

Anterior displacement of wrist
Radial fracture

64
Q

What bone is injured in a boxes fracture?

A

5th metacarpal

65
Q

What bone is injured in a Bennet’s fracture?

A

1st metacarpal

66
Q

What causes a Bennet’s fracture?

A

Forced hyperabduction of the thumb

67
Q

List the carpal bones of the proximal row?

A

Scaphoid
Lunate
Triquetrum
Pisiform

68
Q

List the carpal bones in the distal radius?

A

Trapezium
Trapezoid
Capitate
Hamate

69
Q

What vessel is at risk in a scaphoid fracture?

A

Dorsal carpal branch of radial artery

70
Q

Where does 75% of breast lymph drain?

A

Axillary lymph nodes

71
Q

What nerve can be affected by axillary lymph node clearance

A

Long thoracic nerve

72
Q

What is transmitted in the Guyon’s canal?

A

Ulnar neurovascular bundle including:
Ulnar nerve
Ulnar artery
Lymph nodes
Venae camitantes of ulnar artery

73
Q

What forms the lateral border of the Guyon canal?

A

Hook of hamate

74
Q

What forms the medial border of the Guyon canal?

A

Pisiform
Flexor carpi ulnaris
Adductor digiti minimi

75
Q

What forms the roof of the Guyon canal?

A

Palmar canal ligament

76
Q

What forms the floor of the Guyon canal?

A

Flexor retinaculum

77
Q

In carpal tunnel syndrome, what muscle is unaffected?

A

Flexor pollicus longus

78
Q

What muscle is responsible for increasing grip / increasing curvature of the hand?

A

Palmaris brevis

79
Q

What are the contects of the anatomical snuffbopx?

A

Radial artery
Cephalic vein
Superficial branch of radial artery

80
Q

What muscles are found in the axilla region?

A

Coracobrachialis
Biceps brachii

81
Q

What forms the lateral wall of the axilla region?

A

Humerus

82
Q

What forms the medial wall of the axilla region?

A

Serratus anterior
Thoracic wall

83
Q

WHat forms the anterior wall of the axilla region?

A

Pectoralis major

84
Q

What forms the posterior wall of the axilla region?

A

Subscapularis
Teres major
Latissimus dorsi

85
Q

Where is the axilla region found?

A

Underneath the glenohumeral joint

86
Q

What condition is cuased when the axilla region is compressed?

A

Thoracic outlet syndrome

87
Q

What condition is caused when the axilla region is compressed?

A

Thoracic outlet syndrome

88
Q

What forms the roof of the carpal tunnel?

A

Flexor retinaculum

89
Q

What are the clinical signs of De Quervian’s tenosynovitis?

A

Pain at base of thumb
Unable to grasp and pinch

90
Q

What muscles are found in the anterior compartment of the upper arm?

A

Bracialis
Biceps Brachii
Coracobrachialis

91
Q

Where does the long head of the biceps brachii attach?

A

Scapula - on the supraglenoid tubercle

92
Q

What nerve innervates the anterior compartment of the upper arm

A

Musculocutaneous
(radial does help innervate the brachialis)

93
Q

What nerve root is tested in the bicep tendon reflex?

A

C6

94
Q

What is damaged when Popeye’s sign is seen?

A

Rupture of long head of the biceps brachii

95
Q

What muscles are found in the posterior compartment of the upper limb?

A

Triceps brachii

96
Q

What artery supplies the blood supply to the anterior compartment of the upper arm?

A

Brachial artery

97
Q

What is the arterial supply to the posterior compartment of the upper arm?

A

Profunda Brachii artery

98
Q

What nerve supplies the posterior compartment of the upper arm?

A

Radial nerve

99
Q

What nerve root is tested when eliciting triceps refelx?

A

C7

100
Q

Where does the long head of the triceps brachii originate?

A

Infraglenoid tubercle

101
Q

What is the main nerve supply to the arnterior forearm?

A

Median nerve

102
Q

What muscle can be absent in 15% of the population?

A

Palmaris longus

103
Q

What mvoements are the anterior foearm compartment muscles reponsible for?

A

Pronation forearm
Flexion of wrist
Flexion of fingers

104
Q

List the 5 main arterial vessels of the upper limb from proximal to distal?

A

Subclavian
Axilary
Brachial
Radial
Ulnar

105
Q

Where do the subclavian arteries originate from?

A

On the right: Brachiocephalic trunk
On the left: Aorta

106
Q

What are the superficial veins of the upper lomb?

A

Cephalic
Basilic

107
Q

What upper limb vein is most commonly used for venepuncture?

A

Medial cubital vein

108
Q

Where is the deep venous system of the upper limb found?

A

Under the deep fascia

109
Q

What are the deep veins of the upper limb?

A

Paired vessels
Aka vena comitantes
Run alongside the brachial artery

110
Q

List the components of the flexor pulley system

A

Long flexor tendons (and their assoc synovial sheaths)
Annular pulleys
Cruciate pulleys
Oblique pulleys

111
Q

How many annular pulleys are there?

A

5 in each finger - 2 with thumb

112
Q

How many cruciate pulleys are there?

A

3 acssociated with each finger

113
Q

How manyt oblique pulleys are there

A

One - assocaited ith the thimb

114
Q

Where do the long flexor tendons originate from?

A

The flexor digitorum superficialis

115
Q

What pulley is most commonly assocaited with trigger finger?

A

A1

116
Q

What type of joints are the PIPS?

A

Synovial hinge joint

117
Q

What type of joint is the sternoclavicular?

A

Saddle type synovial joint

118
Q

What 3 structures are involved in the sternoclavicular joint?

A

Sternal manubrium
Sternal end of clavicle
1st costal cartilage

119
Q

What 2 ligaments connects the scapula and the clavicle?

A

Conoid ligament
Trapezoid ligament
aka coracoclavicular ligement

120
Q

Fractures of the anatomical humeral neck are high risk for what?
How should they be managed>

A

Avascular necrosis
Hemiarthroplasty / surgical intervention

121
Q

How is a fracture to the surgical neck of humeral head typically managed?

A

Collar and cuff for three weeks then physiotherapy.

Note: displaced fractures may require open reduction and fixation

122
Q

What is a hills-sach lesion associated with?

A

Glenohumeral dislocation

123
Q
A