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1st Year Med > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

what is the prehensile limb (upper limb) specialised to do?

A

to reach and grasp objects
less consideration for weight bearing

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2
Q

why is the upper limb susceptible to dislocation?

A

limited fixation to axial skeleton

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3
Q

what are the anterior and posterior connections between the axial skeleton and the upper limb?

A

anterior - sternoclavicular joint
posterior - vertebral column muscles

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4
Q

name the movements of the upper limb

A

flexion/extention
abduction/adduction
internal/external rotation
circumduction

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5
Q

name the movements of the elbow

A

flexion/extention
pronation/supination

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6
Q

name the movements of the wrist

A

flexion/extention
abduction/adduction

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7
Q

what is circumduction?

A

circular movement of any ball and socket joint

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8
Q

what is pronation and supination?

A

forearm rotation
moves palm from anterior to posterior facing

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9
Q

what is apposition?

A

gripping between fingers and thumb

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10
Q

where does the clavicle run?

A

runs from manubrium (sternum) to the acromiom (scapula)

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11
Q

what is the function and directions of sigmoid curves in the clavicle?

A

lateral - concave
medial - convex
gives space for vessels/nerves

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12
Q

what is the function of the clavicle?

A

acts as strut (resists compression)
transmits weight

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13
Q

describe the structure of the scapula

A

large flat triangular bone

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14
Q

name the processes of the scapula

A

acromiom process
spine of scapula
coracoid process
medial border
glenoid cavity

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15
Q

what muscles hold the scapula in place?

A

trapezius
levator scapulae
rhomboids major/minor
serratus anterior
pectoralis minor

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16
Q

describe the movements of the scapula

A

protraction/retraction
lateral/medial rotation
abduction/adduction
elevation/depression

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17
Q

name the landmarks of the axilla

A

apex
floor
medial/lateral walls
anterior/posterior walls

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18
Q

pectoralis major (clavicular head): origin and insertion

A

origin - anterior surface of medial clavicle

insert - intertubular sulcus of humerus

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19
Q

pectoralis major (clavicular head): actions and innervation

A

actions - flexes/adducts humerus, depresses scapula

innervation - medial pectoral nerve

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20
Q

pectoralis major (sternocostal head): origins and insert

A

origins - anterior sternum, costal cartilages 1-6, external oblique aponeurosis

insert - intertubular sulcus of humerus

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21
Q

pectoralis major (sternocostal head): actions and innervation

A

actions - extend/adducts humerus, depresses scapula

innervation - lateral pectoral nerve

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22
Q

pectoralis minor: origin and insertion

A

origin - ribs 3-5

insert - coracoid process of scapula

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23
Q

pectoralis minor: actions and innervation

A

actions - shoulder depression, pulls scapula and shoulder forward, raises ribs

innervation - medial pectoral nerve

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24
Q

serratus anterior: origin and insertion

A

origin - lateral ribs 1-8

insert - medial border of scapula (costal surface)

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25
Q

serratus anterior: actions and innervation

A

actions - rotates scapula, holds scapula on ribcage

innervation - long thoracic nerve

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26
Q

what is the brachial plexus?

A

ventral rami of C5-T1 spinal nerve roots

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27
Q

what and where does the brachial plexus supply?

A

sensory/motor/sympathetic nerve supply to pectoral girdle and upper limb

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28
Q

name the 5 nerves in the brachial plexus

A

musculocutaneous, axillary, median, radial, ulnar

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29
Q

where do the brachial plexus roots emerge?

A

between scalene anterior and medius muscles

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30
Q

where are the brachial plexus trunks located?

A

neck region

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31
Q

where do the anterior divisions of brachial trunks supply?

A

flexor muscles and skin on front of upper limb

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32
Q

where do posterior divisions of the brachial trunks supply?

A

extensors and skin on back of upper limb

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33
Q

name the 3 brachial cords and why they are named as such

A

medial, lateral and posterior
based on position around axillary artery

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34
Q

name the innervations of the lateral cord of the brachial plexus

A

musculocutaneous and median nerve

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35
Q

name the innervations of the medial cord of the brachial plexus

A

median nerve and ulnar nerve

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36
Q

name the innervations of the posterior cord of the brachial plexus

A

radial nerve and axillary nerve

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37
Q

name the 3 main supraclavicular branches of the brachial plexus and what they innervate

A

dorsal scapular - supplies rhomboids
long thoracic - supplies serratus anterior
suprascapular - supplies supraspinatus and infraspinatus

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38
Q

name the 3 main infraclavicular branches of the brachial plexus and what they innervate

A

medial/lateral pectoral - pectoralis muscles
upper/lower subscapular - supplies subscapularis (U/L) and teres major (L)
thoracodorsal - latissimus dorsi

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39
Q

name 2 injuries caused from the radial nerve

A

crutch palsy - prolongued use of crutches
drop wrist - cant extend hand

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40
Q

name an injury caused by median nerve damage

A

carpal tunnel syndrome - numbness/tingling and pain in palm/fingers
caused by repetitive wrist flexion

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41
Q

what are the 2 joints of the pectoral girdle?

A

sternoclavicular and acromioclavicular

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42
Q

what is the sternoclavicular joint?

A

ball and socket joint between manubrium of the sternum and the medial clavicle

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43
Q

what do ligaments do in the sternoclavicular joint?

A

prevents dislocation

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44
Q

what does the sternoclavicular ligament do?

A

thickens the anterior and posterior aspect of the synovial sternoclavicular joint

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45
Q

what does the interclavicular ligament do?

A

connects medial ends of each clavicle

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46
Q

what does the costoclavicular ligament do?

A

strengthens inferior aspect of joint from 1st rib to clavicle

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47
Q

what is the acromioclavicular joint?

A

joint lateral clavicle and acromion process of scapula
gliding synovial joint

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48
Q

what 3 ligaments is the AC joint strengthened by?

A

coracoclavicular
acromioclavicular
coracoacromial

49
Q

what is the glenohumeral joint?

A

synovial joint from head of humerus and glenoid cavity of the scapula
multiaxial ball and socket joint

50
Q

what are the problems of the glenohumeral joint?

A

limited stability due to poor bony fit
loose capsule and ligaments

51
Q

where does the stability of the shoulder joint come from?

A

rotator cuff muscles

52
Q

what increases the surface area of the glenoid fossa around the humerus head?

A

glenoid labrum

53
Q

name the parts of the humerus from superior to interior at the shoulder level only

A

head
anatomical neck
surgical neck
greater tubercle
lesser tubercle
intertrubercle/bicipital groove
deltoid tuberocity

54
Q

where does the distal humerus articulate?

A

articulates with forearm bones
medial - ulna (trochlea)
lateral - radius (capitulum)

55
Q

what is the purpose of the medial and lateral epicondyles on the humerus?

A

muscle attatchment

56
Q

describe the synovial capsule of the glenohumeral joint

A

attatches proximally to scapula (beyond supraglenoid tubercle and margin of labrum)
attaches distally to anatomical head of humerus
contains inner synovial membrane and outer fibrous layer

57
Q

what structures are lined by synovial membranes?

A

non-articular surfaces
bursae (fluid filled sacs) found around most major joints to reduce friction

58
Q

name 4 bursae in the shoulder

A

subacromial
subscapular
subdeltoid
subcoracoid

59
Q

describe the flexion movement from the glenohumeral joint

A

caused by muscles passing anterior to joint
(pectoralis major and anterior deltoid fibres)

60
Q

describe the extension movement of the glenohumeral joint

A

limited from anatomical position: posterior deltoid fibres and lat dorsi

returning to anatomical position:
lat dorsi, teres major, pec major

61
Q

describe the abduction movement in the glenohmeral joint

A

15-30 degrees of movement initiated by supraspinatus
30 degrees to horizontal controlled by deltoid
limb to over head requires lateral rotation of scapula

62
Q

describe the adduction movement of the glenohumeral joint

A

gravity centred
lat dorsi
pec major

63
Q

describe the medial rotation of the glenohumeral joint

A

trunk to anterior humerus:
pec major and lat dorsi

scapula to anterior humerus: subscapularis and teres major

64
Q

describe the lateral rotation of the glenohumeral joint

A

muscles from scapula to posterior humerus - infraspinatus, deltoid (post. fibres) and teres minor

65
Q

name the muscles acting on the shoulder from a distance and what effect they have

A

deltoid, teres major, short head biceps brachii
mechanical impact

66
Q

name the muscles acting closely to the shoulder and what effect they have

A

long head biceps, triceps brachii, rotator cuff
stabilises joint

67
Q

what do the rotator cuff muscles join together?

A

scapula to humerus

68
Q

what do the rotator cuff tendons do?

A

encircle joint and fuse with articular capsule

69
Q

teres minor: origin, insertion, action and innervation

A

origin - lateral scapula

insert - greater tubercle of humerus

actions - lateral rotation and stabilisation

innervation - axillary nerve

70
Q

infraspinatus: origin, insert, actions and innervation

A

origin - medial scapula

insert - greater tubercle of humerus (superior)

actions - lateral rotation and stabilisation

innervation - suprascapular nerve

71
Q

supraspinatus: origin, insert, actions and innervation

A

origin - posterior scapula

insert - superior greater tubercle of humerus

actions - abduction and stabilisation

innervation - suprascapular nerve

72
Q

subscapularis: origin, insert, actions and innervation

A

origin - anterior scapula

insert - lesser tubercle of humerus

actions - medial rotation and stabilisation

innervation - subscapular nerve

73
Q

what kind of joints are in the elbow?

A

hinge synovial joint

74
Q

what are the 3 main joints of the elbow?

A

humeroulnar
humeroradial
proximal radioulnar

75
Q

what is the main stability of the elbow?

A

bony articulations:
trochlea (humerus) and olecranon (ulna)

76
Q

explain the position of the ulna

A

medial - larger than radius

77
Q

what landmarks are present at the proximal end of the ulna?

A

trochlear notch
2 processes:
olecranon (larger/posterior)
coronoid (smaller/anterior)

78
Q

what landmarks are present at the distal end of the ulna?

A

head (anterior - articulates with radius)
styloid process - (post/med - articulates with wrist ligaments)

79
Q

how does the radius lie?

A

lateral (near thumb)

80
Q

what landmarks are present at the proximal end of the radius?

A

head (articulates with capitulum and radial notch of ulna)
radial tuberosity medially (attaches to biceps)

81
Q

what landmarks are present on the distal end of the radius?

A

styloid process (laterally - articulates to wrist ligaments)
ulnar notch (medially)

82
Q

where does the humeroulnar joint articulate?

A

between trochlea in humerus and trochlear ulnar notch

83
Q

what is the humeroulnar joint reinforced by and what movement does it allow?

A

reinforced by ulnar collateral ligament
allows flexion/extention

84
Q

where does the humeroradial joint articulate between?

A

between the capitulum on the humerus and the radial head

85
Q

what is the humeroradial joint reinforced by and what movement does it allow?

A

reinforced by the radial collateral ligament
allows supination/pronation

86
Q

biceps brachii (long head): origin and insertion

A

origin - supraglenoid tubercle of scapula

insert - radial tuberosity (distal), bicipital aponeurosis

87
Q

biceps brachii (short head): origin and insertion

A

origin - coracoid process of scapula

insert - radial ruberosity (distal), bicipital aponeurosis

88
Q

biceps brachii: actions and innervation

A

actions - forearm supination, arm flexion

innervation - musculocutaneous nerve

89
Q

what is bicipital apneurosis?

A

a flat sheet of CT attaching biceps indirectly to posterior ulnar border

90
Q

coracobrachialis: origin, insertion, actions and innervation

A

origin - coracoid process

insert - medial humerus

actions - shoulder flexion, weak adduction

innervation - musculocutaneous nerve

91
Q

brachialis: origin, insertion, action and innervation

A

origin - anterior distal humerus

insert - coronoid process (ulna)

action - flexes elbow

innervation - musculocutaneous nerve

92
Q

triceps brachii (long head): origin and insertion

A

origin - infraglenoid tubercle of scapula

insert - olecranon of ulna (one converged tendon)

93
Q

triceps brachii (medial head): origin and insertion

A

origin - humerus (inferior to radial groove)

insert - olecranon of ulna (one converged tendon)

94
Q

triceps brachii (lateral head): origin and insertion

A

origin - humerus (superior to radial groove)

insert - olecranon of ulna (one converged tendon)

95
Q

triceps brachii: actions and innervation

A

actions - elbow extension, long head acts on shoulder to steady humerus

innervation - radial nerve

96
Q

where does forearm rotation occur?

A

between forearm bones at radioulnar joint
around axis from radial head to ulna styloid process
below & independant of shoulder/elbow

97
Q

explain the anatomical features of pronation

A

palm turned posteriorly
proximal radius lateral to ulna
distal radius medial to ulna

98
Q

explain the anatomical features of supination

A

palm turned anteriorly
radius lateral and parallel to ulna

99
Q

explain the structure of the superior radioulnar joint

A

pivot joint between radius head and radial notch on ulna
associated with elbow
held in place by radial annular ligament that runs around radial head

100
Q

describe the structure of the inferior radioulnar joint

A

pivot synovial joint going from ulnar head to ulnar notch on radius
held together by articular disk and interosseus membrane

101
Q

what is the interosseus membrane?

A

thin fibrous tissue separating bones (radius and ulna)

102
Q

what does the interosseus membrane do?

A

site of attachment for forearm muscles
divides forearm into ant and post

103
Q

when does the interosseus membrane change from relaxed to tense?

A

pronation -> supination

104
Q

name the muscles in the anterior compartment of the forearm, and whether they are superficial, intermediate or deep

A

flexor carpi ulnaris (S)
palmaris longus (S)
flexor carpi radialis (S)
pronator teres (S)
flexor digitorum superficialis (I)
flexor pollicis longus (D)
flexor digitorum profundus (D)
pronator quadratus (D)

105
Q

name the superficial muscles in the posterior compartment of the forearm

A

extensor carpi radialis longus/brevis
extensor digitorum
extensor carpi ulnaris
extensor digiti minimi
anconeus
brachioradialis

106
Q

name the deep muscles in the posterior compartment of the forearm

A

supinator
abductor pollicis longus
extensor pollicis brevis/longus
extensor indicis

107
Q

what is the cubital fossa?

A

a triangular depression anterior to elbow joint

108
Q

what is the cubital fossa (triangular depression) bound by?

A

brachioradialis (laterally)
pronator teres (medially)

109
Q

what does the brachial artery diverge into when it enters the base of the cubital fossa?

A

radial and ulnar arteries

110
Q

explain the nerves in the cubital fossa

A

medial nerve runs through
radial nerve located laterally

111
Q

explain the structure of the superficial forearm muscles

A

often long muscles
run from humerus to hand (acting on elbow/wrist) or humerus to digits (acting on elbow, wrist and digits)

112
Q

explain the structure of the deep forearm muscles

A

arise from forearm bones and pass to digits (acting on wrist and digit joints)

113
Q

anterior compartment forearm mucles: actions, innervations and arterial supply

A

actions - forearm pronation, wrist/finger flexion

innervations - median nerve

arterial supply - ulnar/radial artery

114
Q

posterior compartment forearm muscles: actions, innervation and arterial supply

A

actions - wrist/finger extension

innervation - radial nerve

arterial supply - posterior interosseus artery

115
Q

name the 2 muscles in the anterior forearm compartment that are innervated differently

A

flexor carpi ulnaris and flexor digitorum profundus (medial half)
innervated by ulnar nerve

116
Q

teres major: origin and insertion

A

origin - posterior surface of scapula (inferior angle)

insert - intertubular sulcus of humerus (medial lip)

117
Q

teres major: actions and innervation

A

actions - adducts/extends shoulder, medially rotates arm

innervation - lower subscapular nerve

118
Q

deltoid: origins and insertion

A

origins - lateral clavicle, acromiom and scapula spine

insert - deltoid tuberosity of humerus (lateral)

119
Q

deltoid: actions and innervation

A

actions:
anterior - flexion, medial rotation
posterior - extension, lateral rotation
middle - arm abduction

innervation - axillary nerve

1st Year Med (52 decks)

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