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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
What is the motor and sensory function of the musculocutaneous nerve?
Motor= Anterior compartment of the arm (3 bicep muscles) Sensory= lateral cutaneous nerve of forearm
26
What is the motor and sensory function of the radial nerve?
Motor= Extensors of wrist and hand Sensory = Posterior arm, forearm and hand
27
What is the motor and sensory function of the axillary nerve?
Motor= deltoid and teres major Sensory= skin over deltoid
28
What are the 3 muscles of the anterior compartment of the arm? What nerve supplies them?
Bicep brachii Brachialis Coracobrachialis All supplied by the musculocutaneous nerve
29
What is the action of the biceps brachii? What are the 2 heads of the biceps brachii and what way around are they?
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
30
What is the action of the Coracobrachialis?
Arm flexion at shoulder (lifts arm up forwards) and weak arm adduction (lat raise basically)
31
What is the action of the brachialis and where is it attached?
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
32
What are the 2 sticky out bits at the distal end of the humerus?
Medial and lateral epicondyle (medial epicondyle is far more obvious)
33
What accommodates the coronoid process and radial head in full flexion?
Coronoid process is accommodated by the coronoid fossa Radial head is accommodated by the radial fossa
34
What is the extension of the ulna called that extends posteriorly around the coronoid process?
Olecranon process. This is the bony bit of your elbow.
35
What is the joint between the radius and ulna called?
Distal radioulnar joint (DRUJ)
36
How many phalanges bones does the thumb have?
2 - Just a proximal and distal (no middle)
37
What are the MCP and CMC joints?
Carpometacarpal joints - between carpals and metacarpals Metacarpophalangeal joints- between metacarpals and phalanges
38
What are the joints between phalanges called?
Interphalangeal joints
39
What is the styloid process?
This is the bony bit that sticks out on the distal end of the radius and ulna.
40
What is the capitulum?
This the knob at the end of the humerus that articulates with the Radius
41
What is the Trochlea?
This the knob at the end of the humerus that articulates with the ulna
42
What is the annular ligament?
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.
43
What vein runs alongside the lateral side of the forearm?
Cephalic vein
44
What vein runs alongside the medial side of the forearm?
Basilic vein
45
What vein connects the Basilic and Cephalic vein?
Median cubital vein
46
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?
Brachioradialis Lateral side Pronator teres- Medial side
47
What muscles form the floor of the cubital fossa?
Brachialis and Supinator
48
What nerve is very close to the brachial artery?
Median nerve
49
What two arteries does the brachial artery divide into?
Radial artery and ulnar artery
50
What nerve is under the Brachioradialis?
Radial nerve
51
What is the funny bone nerve called? Where are the 2 points it can be damaged?
Ulnar nerve Can be pinched against medial epicondyle Can be compressed by 2 heads of flexor carpi ulnaris
52
What are the 4 muscles in the most superficial layer of the forearm called going from lateral to medial side?
Pronator teres Flexor carpi radialis Palmaris longus- very long tendon- weak flexor of forearm Flexor carpi ulnaris
53
What is the muscle on the anterior layer 2 of the forearm?
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
What are the muscles on the 3rd anterior layer of the forearm?
Lateral side- Flexor pollicis longus Medial side- Flexor digitorum profundus (deeper to the flexor digitorum superficialis and extends to the distal phalanges)
55
What is the deepest muscle in the anterior forearm?
Pronator quadratus
56
What nerve are the majority of muscles in the anterior forearm innervated by?
Median nerve
57
What muscles of the anterior forearm are innervated by the ulnar nerve?
Flexor carpi ulnaris Flexor digitorum profundus (medial part)
58
What is the point of the flexor retinaculum?
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
What are venae comitantes?
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
What is the difference between the superficial palmar arch and the deep palmar arch?
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
What do nerves innervate the ring finger?
Ulnar and median nerve. Ulnar nerve is medial side while median nerve is lateral side.
62
What are the intrinsic muscles of the hand?
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
Where does the cephalic vein travel in the shoulder region?
Between the deltoid and the pectoralis major
64
What 2 veins does the subclavian vein split into?
Cephalic vein and axillary vein
65
What are the two side borders of the scapula called?
Lateral border of scapula and medial border of scapula
66
What is the bottom of the scapula called?
Inferior angle
67
What are the 2 processes on the scapula called?
Top and larger= acromion process Bottom and smaller= coracoid process
68
What part of the scapula connects to the humerus?
Glenoid cavity
69
What muscles act on the upper limb but are not innervated by the brachial plexus?
Trapezius- Accessory nerve Levator scapula- Cervical spine innervation
70
Why is the surgical neck of the humerus named liked this?
This is the point where a fracture is most likely to occur
71
What branch of the brachial plexus lies in close proximity to the surgical neck of the humerus?
The axillary nerve
72
Which head of the biceps brachii is more medial?
Short head
73
What two veins are connected by the median cubital fossa?
Cephalic and Basilic vein
74
What is the superficial palmar arch?
This is a loop in the palm of the hand where the superficial branches of the radial and ulnar artery join
75
What nerve innervates pectoralis major?
Medial and lateral pectoral nerves
76
Why does bending over and breathing help you to recover after a hard effort?
Relaxes the accessory muscles and helps the diaphragm into a more domed position.
77
Where do the anterior and posterior circumflex humeral arteries arise from and where do they go?
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
What is meant by collateral circulation and why is it improtant?
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
What effect does each of the part of the trapezius muscle have on the scapula?
Superior part= Elevates the scapula Middle part= retract the scapula (pull it towards vertebral column) Inferior= Depress the scapula
79
What is the function of lymph nodes?
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
What muscles make up the thenar eminence? What nerve innervates them all?
Flexor Pollicis Brevis, Abductor pollicis brevis, adductor pollicis, opponens pollicis Median nerve
80
What is the distal attachment of the palmaris longus?
Palmar aponeurosis
81
In how many planes is there movement in the sternoclavicular joint?
2
82
What ligament surrounds the sternoclavicular joint and joins the 2 clavicle bones together?
Interclavicular joint
83
What fibrocartilage is present on the glenoid cavity?
Glenoid labrum
84
What are the Scapular movements?
Elevation and Depression, Protraction and retraction, Upward and Downward rotation
85
How does the trapezius allow for movement in multiple planes?
As it has ascending, descending and horizontal fibres which can pull the muscle in different directions?
86
What are the 3 types of fibre in the deltoid?
Anterior, Middle and Posterior parts
87
What is the innervation of the trapezius, deltoid and latissimus dorsi?
Trapezius motor innervation= Spinal accessory nerve Deltoid= axillary nerve Latissimus Dorsi= Thoracodorsal nerve
88
What nerve innervates the rhomboids and levator scapulae?
Dorsal scapular nerve
89
What muscles lie on the scapula?
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
Which nerve innervates Teres Major?
Lower subscapular nerve (branch of brachial plexus)
91
What is important about the actions of Teres major and teres minor?
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
Where does the supra scapular nerve run through in the scapula?
Suprascapular notch
93
What nerve does the sensory nerves for the trapezius run through?
C3 and C4 nerves (different from motor function which is unusual)
94
What are bursae?
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
How many heads of the triceps are there? What are they called?
3- Long head of triceps, medial head of triceps, lateral head of triceps
96
What side are the fibres on teres major on in relation to the long head of the triceps?
Anterior side
97
What nerve innervates each head of the tricep?
Radial nerve
98
Which head of the triceps has a scapular attachment?
Long head of triceps
99
What nerve and vessel goes through the spiral groove of the humerus? What increases the chances of these getting damaged?
Radial nerve and deep brachial artery A break at the surgical neck of the humerus often results in these becoming damaged.
100
Which fingers have two extensor tendons attached?
Index finger and pinky finger
101
What nerve innervates all the extensor muscles of the posterior hand?
Radial nerve
102
What lies over the dorsum of the wrist joint over the extensor tendons?
Extensor retinaculum
103
Which tendon is more lateral: Abductor pollicis longus or extensor pollicis brevis?
Abductor pollicis longus.
104
What are the boundaries of the anatomical snuff box? What artery passes through here?
Extensor pollicis longus on medial side and extensor pollicis brevis on lateral side. Radial artery
105
What ligament creates the suprascapular foramen? Initially it was just a suprascapular notch
Transverse scapular ligament
106
What blood vessel provides a blood supply to many of the superficial and deep extensors of the posterior compartment of the arm?
Posterior interosseus artery
107
Where does the long head of the tricep brachii attach?
Onto the infraglenoid tubercle of the scapula
108
What nerve/vessels travel through the quadrangular space?
Axillary nerve Posterior circumflex humeral artery
109
What nerve/vessels travel through the triangular space?
Radial nerve Produnda brachii artery
110
Where is the common extensor tendon?
On the lateral epicondyle- this is where the extensor muscles originate from
111
What flexor is in the posterior compartment of the forearm?
Brachioradialis
112
What 3 muscles extend the wrist?
Extensor Carpi Ulnaris, Extensor carpi radialis longus, extensor carpi radialis brevis
113
What 3 muscles extend the medial 4 fingers?
Extensor digitorum, Extensor digit minima, extensor indicis
114
What 3 muscles act on the thumb?
Abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus
115
What muscle brings about supination of the forearm?
Supinator (very deep)
116
What is the extensor expansion?
Surrounds the lateral and posterior edges of the tendons of each digit. They are an aponeurosis.
117
What movement do the palmar interosseous muscles bring about?
Adduction of the fingers PAD (DAB)
118
What movement do the dorsal interosseous muscles bring about?
Abduction of the fingers (PAD) DAB
119
What bone is in the floor of the anatomical snuffbox?
Scaphoid
120
What artery goes through the anatomical snuff box?
Radial artery (blood supply to scaphoid)
121
What is the main artery and vein of the posterior compartment of the arm?
Artery= Interosseous artery Vein= Venae comitantes
122
What is the main blood supply in the hand?
Deep and superficial palmar arches
123
What nerve innervates the palmar and dorsal interossei?
Ulnar nerve
124
What nerve innervates the hypothenar muscles?
Ulnar nerve
125
What is avascular necrosis?
This is the death of bone tissue due to a lack of blood supply (can be caused by fracture of the scaphoid bone)
126
What is the quadrate ligament?
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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