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Medicine > Upper limb > Flashcards

Upper limb Flashcards

1
Q

What muscle connects the humerus and scapula?

A

Teres major

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2
Q

What is the axilla?

A

This is an anatomical region under the armpit where the shoulder joint connects to the armpit.

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3
Q

What are the 3 parts of the pectoralis major?

A

Clavicular head- Top
Sternocostal head- Main middle bit
Abdominal head- Bottom

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4
Q

What actions in the pectoralis major responsible for? (there are 4!)

A

Arm adduction
Arm abduction
Arm flexion (clavicular head)- lifting the arm straight in front of you
Arm medial rotation- Rotates the shoulder inwards

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5
Q

What are the proximal attachments (origin) of the pectoralis major?

A

Clavicular head attaches to the medial half of the clavicle
Sternocostal head attaches to the upper costal cartilages (1-6), and the aponeurosis of the external oblique

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6
Q

What are the distal attachments (insertion) of the pectoralis major?

A

On the crest of the greater tubercle of the humerus
Lateral lip of the intertubercular (bicipital) groove of the humerus

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7
Q

What are the actions of the pectoralis minor?

A

Stabilisation of scapula against the thoracic wall- pulls it forwards and downwards
Accessory muscle of respiration (helps draw the ribs upwards)

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8
Q

What are the proximal and distal attachments of the pectoralis minor?

A

Proximal = Anterior surface of the sternal ends of the ribs 3-5
Distal= coracoid process of scapula

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9
Q

What are the actions of the serratus anterior?

A

Protraction of Scapula- abducts and upwardly rotates it when you move you arm out
Stabilisation of scapula against thoracic wall- keeps the scapula close to the thoracic wall

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10
Q

What are the proximal and distal attachments of the serratus anterior?

A

Proximal = Anterior surfaces of the first 8 or 9 ribs
Distal = Anterior surface of the medial border of the scapula

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11
Q

What nerves supply each of the 3 pectoral muscles?

A

Pectoralis major- Medial and lateral pectoral nerves
Pectoralis minor- Medial pectoral nerve
Serratus anterior- Long thoracic nerve

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12
Q

What 2 muscles are either site of the axilla?

A

Anterior= Pectoralis major
Posterior= Latissimus dorsi

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13
Q

Describe the changes in the subclavian artery to the forarm?

A

Subclavian artery
Axillary artery
Brachial artery
Splits into Radial artery and Ulnar artery

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14
Q

What 2 veins join to the form the axillary vein?

A

Brachial and basilic vein

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15
Q

What spinal nerves supply the brachial plexus?

A

C5-T1

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16
Q

What is the brachial plexus?

A

A network of nerves that supplies the skin and musculature of the upper limb. It begins in the root of the neck, passes through the axilla and then into the whole of the arm

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17
Q

What are the 5 divisions of the brachial Plexus?

READ THAT DAMN CADAVER BOOK!

A

Roots
Trunks
Division
Cords
Branches

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18
Q

What roots join in the brachial plexus to form what trunks?

A

C5 and C6 join- form superior trunk
C7 stays alone- form middle trunk
C8 and T1 join- form interior trunk

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19
Q

What divisions of the 3 trunks of the brachial plexus form?

A

Superior and middle trunk join to form an anterior division
Inferior trunk has its own anterior division
All 3 trunks join to form a posterior division

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20
Q

What are the Lateral, Posterior and Medial cords formed from?

A

Lateral- From the anterior division of the superior and middle trunks
Posterior- from the posterior divisions of all 3 trunks
Medial- From the anterior division of the inferior trunk

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21
Q

What are the 5 major branches of the brachial plexus?

A

Musculocutaneous nerve- C5,6,7
Axillary nerve- C5,6
Radial nerve- C5-T1
Median nerve- C6-T1
Ulnar nerve- C8-T1

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22
Q

What is a good landmark to look out for when dissecting the brachial plexus?

A

The M shape at the end of it formed by the musculocutaneous, medial and ulnar nerves

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23
Q

What is the motor and sensory function of the median nerve?

A

Motor= flexors of wrist and finger
Sensory= Lateral area of the hand

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24
Q

What is the motor and sensory function of the Ulnar nerve?

A

Motor= small muscles of hand
Sensory = medial area of hand

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25
Q

What is the motor and sensory function of the musculocutaneous nerve?

A

Motor= Anterior compartment of the arm (3 bicep muscles)
Sensory= lateral cutaneous nerve of forearm

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26
Q

What is the motor and sensory function of the radial nerve?

A

Motor= Extensors of wrist and hand
Sensory = Posterior arm, forearm and hand

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27
Q

What is the motor and sensory function of the axillary nerve?

A

Motor= deltoid and teres major
Sensory= skin over deltoid

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28
Q

What are the 3 muscles of the anterior compartment of the arm? What nerve supplies them?

A

Bicep brachii
Brachialis
Coracobrachialis

All supplied by the musculocutaneous nerve

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29
Q

What is the action of the biceps brachii?

What are the 2 heads of the biceps brachii and what way around are they?

A

Supinates forearm (rotation of the forearm away laterally)
Flexion of arm when forearm is supinated

Long and Short head. Short head is medial to long head

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30
Q

What is the action of the Coracobrachialis?

A

Arm flexion at shoulder (lifts arm up forwards) and weak arm adduction (lat raise basically)

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31
Q

What is the action of the brachialis and where is it attached?

A

Action is flexion at the elbow joint.

Deeper than the biceps brachii. Originates from the medial and lateral surfaces of the humeral shaft and inserts into the ulnar tuberosity just distal to the elbow joint

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32
Q

What are the 2 sticky out bits at the distal end of the humerus?

A

Medial and lateral epicondyle (medial epicondyle is far more obvious)

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33
Q

What accommodates the coronoid process and radial head in full flexion?

A

Coronoid process is accommodated by the coronoid fossa
Radial head is accommodated by the radial fossa

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34
Q

What is the extension of the ulna called that extends posteriorly around the coronoid process?

A

Olecranon process. This is the bony bit of your elbow.

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35
Q

What is the joint between the radius and ulna called?

A

Distal radioulnar joint (DRUJ)

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36
Q

How many phalanges bones does the thumb have?

A

2 - Just a proximal and distal (no middle)

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37
Q

What are the MCP and CMC joints?

A

Carpometacarpal joints - between carpals and metacarpals
Metacarpophalangeal joints- between metacarpals and phalanges

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38
Q

What are the joints between phalanges called?

A

Interphalangeal joints

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39
Q

What is the styloid process?

A

This is the bony bit that sticks out on the distal end of the radius and ulna.

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40
Q

What is the capitulum?

A

This the knob at the end of the humerus that articulates with the Radius

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41
Q

What is the Trochlea?

A

This the knob at the end of the humerus that articulates with the ulna

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42
Q

What is the annular ligament?

A

This wraps around the head of the proximal end of the radius and stops the radius from moving during supination and pronation. It forms about 4/5 of a circle round the radius.

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43
Q

What vein runs alongside the lateral side of the forearm?

A

Cephalic vein

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44
Q

What vein runs alongside the medial side of the forearm?

A

Basilic vein

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45
Q

What vein connects the Basilic and Cephalic vein?

A

Median cubital vein

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46
Q

What muscle is the powerful flexor of the elbow on the lateral side called?
What boundary of the cubital fossa is this?
What muscle is on the other side?

A

Brachioradialis
Lateral side
Pronator teres- Medial side

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47
Q

What muscles form the floor of the cubital fossa?

A

Brachialis and Supinator

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48
Q

What nerve is very close to the brachial artery?

A

Median nerve

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49
Q

What two arteries does the brachial artery divide into?

A

Radial artery and ulnar artery

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50
Q

What nerve is under the Brachioradialis?

A

Radial nerve

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51
Q

What is the funny bone nerve called?
Where are the 2 points it can be damaged?

A

Ulnar nerve
Can be pinched against medial epicondyle
Can be compressed by 2 heads of flexor carpi ulnaris

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52
Q

What are the 4 muscles in the most superficial layer of the forearm called going from lateral to medial side?

A

Pronator teres
Flexor carpi radialis
Palmaris longus- very long tendon- weak flexor of forearm
Flexor carpi ulnaris

53
Q

What is the muscle on the anterior layer 2 of the forearm?

A

Flexor digitorum superficialis- divides into 4 tendons that go down to middle phalanx of the 4 digits.

You can see it wiggling when you wiggle your fingers

54
Q

What are the muscles on the 3rd anterior layer of the forearm?

A

Lateral side- Flexor pollicis longus
Medial side- Flexor digitorum profundus (deeper to the flexor digitorum superficialis and extends to the distal phalanges)

55
Q

What is the deepest muscle in the anterior forearm?

A

Pronator quadratus

56
Q

What nerve are the majority of muscles in the anterior forearm innervated by?

A

Median nerve

57
Q

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

A

Flexor carpi ulnaris
Flexor digitorum profundus (medial part)

58
Q

What is the point of the flexor retinaculum?

A

This creates a carpal tunnel which some tendons and muscles travel through to prevent bowstringing.

Flexor digitorum profundus, flexor digitorum superficialis, flexor pollicis longus and median nerve all travel through here (if you have inflammation of any of the muscles then they can compress against the median nerve which can lead to problems)

59
Q

What are venae comitantes?

A

These are paired veins that both travel alongside an artery. They are found very close so the pulsations of the artery aid the movement of blood along the veins and back to the heart.

60
Q

What is the difference between the superficial palmar arch and the deep palmar arch?

A

Superficial palmar arch is formed from the superficial branch of the ulnar artery and radial artery while the deep palmar arch is formed from the deep branches of the ulnar and radial artery

61
Q

What do nerves innervate the ring finger?

A

Ulnar and median nerve. Ulnar nerve is medial side while median nerve is lateral side.

62
Q

What are the intrinsic muscles of the hand?

A

Lumbricals
Thenar eminence- collection of muscles at the base of the thumb
Hypothenar eminence- collection of muscles at the base of the little finger
Palmar interossei muscles

63
Q

Where does the cephalic vein travel in the shoulder region?

A

Between the deltoid and the pectoralis major

64
Q

What 2 veins does the subclavian vein split into?

A

Cephalic vein and axillary vein

65
Q

What are the two side borders of the scapula called?

A

Lateral border of scapula and medial border of scapula

66
Q

What is the bottom of the scapula called?

A

Inferior angle

67
Q

What are the 2 processes on the scapula called?

A

Top and larger= acromion process
Bottom and smaller= coracoid process

68
Q

What part of the scapula connects to the humerus?

A

Glenoid cavity

69
Q

What muscles act on the upper limb but are not innervated by the brachial plexus?

A

Trapezius- Accessory nerve
Levator scapula- Cervical spine innervation

70
Q

Why is the surgical neck of the humerus named liked this?

A

This is the point where a fracture is most likely to occur

71
Q

What branch of the brachial plexus lies in close proximity to the surgical neck of the humerus?

A

The axillary nerve

72
Q

Which head of the biceps brachii is more medial?

A

Short head

73
Q

What two veins are connected by the median cubital fossa?

A

Cephalic and Basilic vein

74
Q

What is the superficial palmar arch?

A

This is a loop in the palm of the hand where the superficial branches of the radial and ulnar artery join

75
Q

What nerve innervates pectoralis major?

A

Medial and lateral pectoral nerves

76
Q

Why does bending over and breathing help you to recover after a hard effort?

A

Relaxes the accessory muscles and helps the diaphragm into a more domed position.

77
Q

Where do the anterior and posterior circumflex humeral arteries arise from and where do they go?

A

They branch off from the axillary artery and each wrap around the surgical neck of the humerus (anterior round the front and posterior round the back)

78
Q

What is meant by collateral circulation and why is it improtant?

A

This means that vessels go the whole way around a bone and is important if a vessel gets blocked, blood can still travel the other way around a bone.

79
Q

What effect does each of the part of the trapezius muscle have on the scapula?

A

Superior part= Elevates the scapula
Middle part= retract the scapula (pull it towards vertebral column)
Inferior= Depress the scapula

79
Q

What is the function of lymph nodes?

A

They filter the blood to remove harmful waste products and initiate an immune response and then return the filtered fluid back into the blood.

79
Q

What muscles make up the thenar eminence?

What nerve innervates them all?

A

Flexor Pollicis Brevis, Abductor pollicis brevis, adductor pollicis, opponens pollicis

Median nerve

80
Q

What is the distal attachment of the palmaris longus?

A

Palmar aponeurosis

81
Q

In how many planes is there movement in the sternoclavicular joint?

A

2

82
Q

What ligament surrounds the sternoclavicular joint and joins the 2 clavicle bones together?

A

Interclavicular joint

83
Q

What fibrocartilage is present on the glenoid cavity?

A

Glenoid labrum

84
Q

What are the Scapular movements?

A

Elevation and Depression, Protraction and retraction, Upward and Downward rotation

85
Q

How does the trapezius allow for movement in multiple planes?

A

As it has ascending, descending and horizontal fibres which can pull the muscle in different directions?

86
Q

What are the 3 types of fibre in the deltoid?

A

Anterior, Middle and Posterior parts

87
Q

What is the innervation of the trapezius, deltoid and latissimus dorsi?

A

Trapezius motor innervation= Spinal accessory nerve
Deltoid= axillary nerve
Latissimus Dorsi= Thoracodorsal nerve

88
Q

What nerve innervates the rhomboids and levator scapulae?

A

Dorsal scapular nerve

89
Q

What muscles lie on the scapula?

A

Posterior aspect:
Supraspinous fossa= supraspinatus
Infraspinous fossa= Infraspinatus
Below Infraspinatus= Teres Minor
(All attached onto the greater tubercle- superior, middle inferior facets)

Anterior Aspect:
Subscapular fossa= subscapularis
(Attached to lesser tubercle)

90
Q

Which nerve innervates Teres Major?

A

Lower subscapular nerve (branch of brachial plexus)

91
Q

What is important about the actions of Teres major and teres minor?

A

Teres major attaches the anterior aspect of the humerus.
Teres Minor attaches to the posterior aspect of the humerus.
This means that they have opposite actions.

92
Q

Where does the supra scapular nerve run through in the scapula?

A

Suprascapular notch

93
Q

What nerve does the sensory nerves for the trapezius run through?

A

C3 and C4 nerves (different from motor function which is unusual)

94
Q

What are bursae?

A

Sacs that contain synovial fluid and reduce friction between moving surfaces (for example, muscle over bone or 2 muscles going over one another). Usually found at synovial joints.

Synovial fluid is produced in the synovial membrane.

95
Q

How many heads of the triceps are there? What are they called?

A

3- Long head of triceps, medial head of triceps, lateral head of triceps

96
Q

What side are the fibres on teres major on in relation to the long head of the triceps?

A

Anterior side

97
Q

What nerve innervates each head of the tricep?

A

Radial nerve

98
Q

Which head of the triceps has a scapular attachment?

A

Long head of triceps

99
Q

What nerve and vessel goes through the spiral groove of the humerus?

What increases the chances of these getting damaged?

A

Radial nerve and deep brachial artery

A break at the surgical neck of the humerus often results in these becoming damaged.

100
Q

Which fingers have two extensor tendons attached?

A

Index finger and pinky finger

101
Q

What nerve innervates all the extensor muscles of the posterior hand?

A

Radial nerve

102
Q

What lies over the dorsum of the wrist joint over the extensor tendons?

A

Extensor retinaculum

103
Q

Which tendon is more lateral: Abductor pollicis longus or extensor pollicis brevis?

A

Abductor pollicis longus.

104
Q

What are the boundaries of the anatomical snuff box?
What artery passes through here?

A

Extensor pollicis longus on medial side and extensor pollicis brevis on lateral side.
Radial artery

105
Q

What ligament creates the suprascapular foramen? Initially it was just a suprascapular notch

A

Transverse scapular ligament

106
Q

What blood vessel provides a blood supply to many of the superficial and deep extensors of the posterior compartment of the arm?

A

Posterior interosseus artery

107
Q

Where does the long head of the tricep brachii attach?

A

Onto the infraglenoid tubercle of the scapula

108
Q

What nerve/vessels travel through the quadrangular space?

A

Axillary nerve
Posterior circumflex humeral artery

109
Q

What nerve/vessels travel through the triangular space?

A

Radial nerve
Produnda brachii artery

110
Q

Where is the common extensor tendon?

A

On the lateral epicondyle- this is where the extensor muscles originate from

111
Q

What flexor is in the posterior compartment of the forearm?

A

Brachioradialis

112
Q

What 3 muscles extend the wrist?

A

Extensor Carpi Ulnaris, Extensor carpi radialis longus, extensor carpi radialis brevis

113
Q

What 3 muscles extend the medial 4 fingers?

A

Extensor digitorum, Extensor digit minima, extensor indicis

114
Q

What 3 muscles act on the thumb?

A

Abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus

115
Q

What muscle brings about supination of the forearm?

A

Supinator (very deep)

116
Q

What is the extensor expansion?

A

Surrounds the lateral and posterior edges of the tendons of each digit. They are an aponeurosis.

117
Q

What movement do the palmar interosseous muscles bring about?

A

Adduction of the fingers

PAD (DAB)

118
Q

What movement do the dorsal interosseous muscles bring about?

A

Abduction of the fingers

(PAD) DAB

119
Q

What bone is in the floor of the anatomical snuffbox?

A

Scaphoid

120
Q

What artery goes through the anatomical snuff box?

A

Radial artery (blood supply to scaphoid)

121
Q

What is the main artery and vein of the posterior compartment of the arm?

A

Artery= Interosseous artery
Vein= Venae comitantes

122
Q

What is the main blood supply in the hand?

A

Deep and superficial palmar arches

123
Q

What nerve innervates the palmar and dorsal interossei?

A

Ulnar nerve

124
Q

What nerve innervates the hypothenar muscles?

A

Ulnar nerve

125
Q

What is avascular necrosis?

A

This is the death of bone tissue due to a lack of blood supply (can be caused by fracture of the scaphoid bone)

126
Q

What is the quadrate ligament?

A

Connects the radius and ulna at the proximal end. Attaches to the inferior border of the radial notch on the ulna and to the neck of the radius

Medicine (42 decks)

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