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Part 1 Anatomy > Upper limb > Flashcards

Upper limb Flashcards

1
Q

Muscle attachments clavicle

A

med 1/3 - ant sup - SCM, ant inf - pec major
mid 1/3 - inf - subclavius
last 1/3 - ant - deltoid, post - trap

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2
Q

Surface markings scapula

A

ribs 2-7

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3
Q

Scapula movements

A

elevation - trap
depression - gravity
protraction - serratus anterior
retraction - trap
upward rotation - trap + serratus ant
Downward rotation - lat dorsi

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4
Q

Structure surgical neck humerus

A

axillary nerve and circumflex humeral vessels

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5
Q

Structures shaft humerus

A

radial nerve and profunda brachii artery in radial/ spiral groove

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6
Q

Pectoral fascia

A

from sternum and clavicle to axillary fascia lat and ant abdominal wall inf
invests pec major

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7
Q

Clavipectoral fascia

A

Deep to pectoral
Invests pec minor and subclavius
costocoracoid membrane between the muscles
suspensory ligament inf

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8
Q

Deltoid fascia

A

from clavicle, acromium and scapular spine
to pectoral fascia and infraspinous

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9
Q

Cephalic vein

A

lateral
deltopectoral groove
clavipectoral triangle
pierces costocoracoid membrane and clavipectoral fascia and enters axillary

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10
Q

Basilic vein

A

medial
pierces deep to brachial fascia 1/3 way up arm
parallel and sup to brachial artery and medial cutaneous nerve

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11
Q

Shoulder myotomes

A

C5 - flexion, lat rotation and abduction
C6-8 - extension, int rotation and adduction

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12
Q

Elbow myotomes

A

C5-6 flexion
C7 (+-6) extension
C6 supination
C7-8 pronation

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13
Q

Wrist myotomes

A

C6/7 flexion and extension

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14
Q

Hand myotomes

A

C7/8 flexion and extension
T1 Finger ab/adduction

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15
Q

Musculocutaneous nerve

A

C567
lateral cord
sensory - lat cut nerve forearm
Motor - BBC, flexion shoulder + elbow + supination

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16
Q

Axillary nerve

A

C56
posterior cord
sensory - sup lat cutaneous of arm
Motor - deltoid (ant terminal branch), teres minor (post terminal branch)

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17
Q

Radial nerve

A

C5-T1
Posterior cord
sens - post cut arm, inf lat cut arm, post cut forearm, superficial/ terminal radial
Motor - extensor compartment forearm + triceps
brachioradialis and extensor carpi longus
Deep terminal branch supplies all other post forearm

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18
Q

Median nerve

A

C6-T1
Medial + lateral cord
sens - palmar cutaneous (not though carpal tunnel), and digital cutaneous
Motor - flexors except flexor carpi ulnaris and ulnar half flexor digitorum profundus
LOAF: thenar muscles (recurrent branch) + lat 2 lumbricals (palmar digital)

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19
Q

Ulnar nerve

A

C8-T1
Medial cord
Sens - palmar cutaneous, dorsal cutaneous, superficial (arises in hand)
Motor - Intrinsic hand (except lat 2 lumbricals) (deep branch), flexor carpi ulnaris and ulnar half flexor digitorum profundus (muscular branch)

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20
Q

Pec major

A

clavicular C56 and sternocostal C78T1 heads to lateral lip intertubercular sulcus humerus
Lat+med pectoral nerves
Adduct + med rot humerus
clavic - flex humerus
Sterno - extends from flexed position

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21
Q

Pec minor

A

ribs 3-5 to coracoid process
med pectoral nerve C8/T1
stabilises scapula

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22
Q

Subclavus

A

junction 1st rib and costal cartilage to int surface middle 1/3 clavicle
nerve to subclavis C56 (sup trunk)

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23
Q

Serratus anterior

A

ribs 1-8 to ant border med scapula
Long thoracic
Protracts and rots scapula

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24
Q

Trapezius innervation

A

XI + C3/4 for proprioception +pain

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25
Q

Lat dorsi

A

From: spin process T6-12, thoracolumbar fascia, inf 3-4 ribs, iliac crest
To: floor intertubercular sulcus humerus
Thoracodorsal nerve C678 post cord
extends, adducts and int rotates humerus

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26
Q

Levator scapulae (deep)

A

Post tubercles C1-4 to med border scapula sup to root spine
dorsal scapular C45 +cervical nerves C34

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27
Q

Rhomboids

A

minor - nuchal lig + spinois C7-T1 to med scap spine
major - T2-5 to medial scap inf to spine
Dorsal scpular nerve C45 (roots)
retracts scapula

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28
Q

Deltoid

A

from lat 1/3 clavicle, acromium and spine scapula to deltoid tuberosity humerus
Axillary c5/6
clav - flex + med rotate
Acrom - abduct
scap - ext and lat rotate

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29
Q

Teres major

A

post surface inf angle scapula to medial lip intertubercular sulcus
lower subscapular nerve (post cord) C56
Med rot and adducts

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30
Q

Axillary artery branches

A

1st (1st rib to sup pec minor) - sup thoracic
2nd (post pec minor) - thoracoacromial + lateral thoracic
3rd (inf pec to inf teres major) - subscapular, post and ant circumflex humeral

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31
Q

Axillary vein

A

formed by basilic and brachial at inf border teres major
Names like arteries excepr thoracoacromial sometimes goes cephalic
receives thoracoepigastric + cephalic

Ant med / inf to axillary artery

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32
Q

Axillary lymph nodes

A

pectoral (ant), subscapular (post) and humeral (lat) drain to central, then apical, then supraclavicular and subclavian trunk

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33
Q

Pectoral lymph node

A

Ant axillary
Medial wall axilla along lat thoracic artery and vein
Inf border pec minor
receives from breast and anterior thoracic wall

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34
Q

Subscapular lymph nodes

A

posterior axillary
by subscapular blood vessels
receives post thoracic wall and scapula

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35
Q

Humeral lymph nodes

A

lateral axillary
Medial and posterior to axillary vein
Drains most upper limb
Except cephalic - apical axillary and infraclavic

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36
Q

Central axillary lymph nodes

A

deep to pec minor by 2nd part axillary artery

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37
Q

Apical axillary lymph nodes

A

1st part axillary artery, medical to axillary vein

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38
Q

Shoulder girdle

A

Bones: clavicle and scapula
Articulations: sternoclavicular and acromioclavicular
Movement:
rhomboids - elevation and downward rotation
Serratus anterior - depression and upward rotation, protraction

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39
Q

Biceps brachii

A

short head - coracoid
Long head - supraglenoid tubercle
Tendon of long head through bicipital groove
To: tuberosity radius and fascia forearm (bicipital aponeurosis)

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40
Q

Brachialis

A

from dist ant humerus to coronoid + tuberosity of ulna

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41
Q

Triceps

A

long - infraglenoid
lat (strongest) - post humerus
med - post humerus
To - prox olecranon + fascia forearm

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42
Q

Aconeus

A

lat humeral epicondyle to lat olecranon
helps extension and stabilises elbow

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43
Q

Corachobrachialis

A

to mid 1/3 med humerus
pierced by musculocutaneous
median nerve and brachial artery run deep

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44
Q

Branches brachial artery

A

Profunda brachii
Nutrient
Sup ulnar collateral
Inf ulnar collateral

Brachial goes with median nerve, which crosses it and becomes medial by ACF

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45
Q

Cubital fossa

A

Med - pronator teres
Lat - brachioradialis
Floor - brachialis and supinator
Contents - brachial artery -> ulnar + radial + veins
Biceps tendon
Radial nerve
Median nerve
med NVA (biceps tendon) N lat

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46
Q

Superficial flexors forearm

A

Flexor carpi ulnaris (innervated ulnar)
Palmaris longus
Flexor carpi radialis
Pronator teres
attached to medial epicondyle by common flexor tendon

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47
Q

Intermediate and deep flexor compartment

A

Int - flexor digitorum superficialis
Deep (all ant IO) - flexor digitorum profundus (+ ulnar), flexor pollicis longus, pronator quadratus

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48
Q

Palmaris longus tendon relations

A

deep and medial to median nerve at wrist

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49
Q

Flexor carpi ulnaris relations

A

ulnar nerve between two proximal heads
ulnar nerve and artery lateral to tendon at wrist

50
Q

Flexor carpi radialis relations

A

radial artery and nerve lateral at wrist

51
Q

Extensor tendon lateral epicondyle

A

extensor carpi radialis brevis
extensor carpi ulnaris
extensor digitorum
extensor digiti minimi

arterial supply ulnar / rad based on name

52
Q

Superior extensor compartment forearm

A

Brachioradialis - rad
ECR longus - rad
ECR brevis - deep
Extensor digitorum - deep
Extensor digiti minimi - deep
Extensor carpi ulnaris - deep

53
Q

Deep extensors of forearm

A

Supinator (deep)
Abductor pollicis longus (post IO)
Extensor pollicis longus (post IO)
Extensor pollicis brevis (post IO)
Extensor indicis (post IO)

(thumb sandwich)

54
Q

Anatomical snuffbox

A

Ulnar side - extensor pollicis longus
Radial side - extensor pollicis brevis and abductor pollicis longus
Radial artery, radial nerve, cephalic vein
Floor - scaphoid and trapezium
prox - rad styloid
dist - 1st metacarp

55
Q

Ulnar artery depth forearm

A

Deep to superficial and intermediate flexors
Superficial to flexor retinaculum

56
Q

Ulnar recurrent artery

A

Supplies brachialis and pronator teres
Anastomoses inf ulnar collateral

57
Q

Common interosseous artery

A

branch of ulnar

58
Q

Post IO artery

A

from ulnar
supplies superfical and deep extensor muscles

59
Q

Ant IO artery

A

from ulnar
Joins dorsal carpal arch

60
Q

Radial artery

A

deep to brachioradialis
Lateral to tendon FCR
Through anatomical snuff box and pierces 1st dorsal interosseous

61
Q

Radial recurrent artery

A

supplies elbow joint
Goes between brachialis and brachioradialis which it supplies
anastomoses radial collateral artery from profunda brachii

62
Q

Quadrangular space

A

humerus, teres minor and major, long head triceps
axillary nerve and posterior circumflex humeral artery

63
Q

Triangular space

A

sup teres minor, lat long triceps, inf teres major
circumflex scapular art and vein

64
Q

Triangular interval

A

sup teres major, lat lat head triceps, med long head triceps
Radial nerve and profunda brachii art and vein

65
Q

Structures passing clavipectoral fascia

A

CALL: Cephalic vein A -thoracoAcrominal artery Lymphatics Lateral pectoral nerve.

66
Q

Contents hypothenar compartment

A

abductor digiti minimi
flexor digiti minimi brevis
oponens digiti minimi

67
Q

Contents thenar compartment

A

Openens pollicis
Abductor pollicis brevis
flexor pollicis brevis

68
Q

Contents central compartment hand

A

lumbricals
superficial palmar arch
digital vessels and nerves

69
Q

Contents adductor compartment hand

A

Adductor pollicis

70
Q

Innervation intrinsic thenar muscles

A

Recurrent medial
Opponens, abductor brevis, sup FPB
Deep ulna
deep FPB
Adductor policis

71
Q

Lumbricals

A

prox - 1+2 unipenate from lat 2 tendons FDP
3+4 (med) bipenate from FDP 3 med tendons
Dist - lat extensor expansion middle phalynx
Flex MCP, extend IPJ

72
Q

Doral interrossei

A

bipenate
prox - adjacent 2 metacarpals
dist - base prox phalynx extensor expansion

73
Q

Palmar interrosei

A

Unipenate
prox palmar 2,4,5 metacarpals
dist - prox phalynx extensor expansion 2,4,5

74
Q

Contents carpal tunnel

A

4x FDP
4x FDL
1x FPL (own tendon sheath, others share)
Median nerve

75
Q

Median hand branches

A

recurrent MOTOR - thenar muscles
lat MIXED - 1st lumb
Med MIXED - 2nd lumb
Palm cut SENS - not through CT

76
Q

Ulnar hand branches

A

palmar cut - SENS
Dorsal branch - SENS
Superficial MIXED - finegr tips + palmaris brevis
Deep MOTOR - hypothenar and most intrinsic

77
Q

Hypothenar muscles

A

Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi
Innervated deep ulnar

78
Q

Superficial and deep palmar arch

A

Sup from ulnar - deep to palmar aponeurosis, sup to flexors
Deep from rad - deep to long flexors, in contact metacarpals

79
Q

Guyons/ ulnar canal

A

med - pisiform, FCU tendon, abd digiti minimi
lat - hook of hamate
roof - palmar carpal lif
floor - flexor retinaculum, pisohamate lig, hypothenar muscles

contents - ulnar nerve, ulnar art and veins, lymph

80
Q

Extensor expansion insertions

A

central slip - base midle phalynx
lateral bands - base distal phalynx

81
Q

SCJ

A

saddle
blood - int thoracic, suprascap
Nerve - supraclavic, subclavian

82
Q

ACJ

A

Plane
blood - suprascap, thoracoacromial
nerve - lat pectoral, axillary

83
Q

Apertures glenohumeral joint

A

between tubercles
between joint and subtendinous bursa subscapularis

84
Q

Ligaments glenohumeral

A

glenohumeral: sup, med, inf (inf stab)
coracohumeral - sup stab
coracoacromial - sup stab
transverse humeral

85
Q

Glenohumeral joint

A

Ball and socket
blood - A+P circumflex, suprascapular
Nerve - axillary, suprascapular, latera pectoral

86
Q

Elbow joint

A

Hinge joint
blood - radial + ulna + collaterals
Nerve - MSC, radial, ulnar

87
Q

Elbow ligaments

A

Colaterals
radial - lat epicondyle to annular lig
med x3 - med epi to olecranon and coronoid process
ant band strongest
post band fan like weakest
obliquie band - deepens socket for trochlea

Annular

88
Q

Proximal radioulnar joint

A

pivot
blood - radial periarticular anastamoses
nerve - MSC, median, radial

89
Q

Distal radioulnar joint

A

pivot
blood + nerve - A+P IO

ulna + radius + articular disc
A+P ligaments

90
Q

Wrist joint

A

condyloid
blood - dorsal and palmar arches
nerve - A+P IO and deep and dorsal ulnar
Scaphoid, lunate and triquetrial

91
Q

Intercarpal joints

A

plane
midcarpal and pisotriquetral
same blood + innervation wrist

92
Q

Carpometacarpal

A

plane except thumb - condyoid
movement good thumb, minimal 2+3, more 4+5

93
Q

MCPJ
IPJ joint types

A

MCPJ condyloid
IPJ hinge

94
Q

Thenar musculature

A

opponens pollicis, flexor pollicis brevis, and abductor pollicis brevis (LOAF muscles - median)

95
Q

forearm muscles supplied by radial nerve proper

A

brachioradialis
ECRL

96
Q

Pronation and supination

A

pronation C78
Supination C6

97
Q

Anterior axillary lymph node location

A

Inferior to pec minor

98
Q

Posterior axillary lymph node location

A

by subscapular vessels

99
Q

Lateral axillary lymph node location

A

axillary artery

100
Q

Bone attaching extensor and flexor retinaclum

A

pisiform

101
Q

Deepest structure mid forearm

A

FPL

102
Q

Attachments extensor retinaculum

A

radius to triquetrium and pisiform

103
Q

Main stabiliser SCJ

A

costoclavicular ligament

104
Q

ossification centres scapula

A

7

105
Q

Main function median thumb

A

flexion

106
Q

Innervation sternoclavicular joint

A

C3/4

107
Q

Innervation ACJ

A

lateral pectoral, axillary and supra clavicular

108
Q

Largest branch brachial artery

A

Profunda brachii

109
Q

Strongest muscle forearm

A

FDP

110
Q

Part of triceps affected in mid shaft radius fracture

A

Medial

111
Q

Ligament for anterior stability shoulder joint

A

Glenohumeral

112
Q

Ligaments for superior stability glenohumeral joint

A

Coracohumeral and coracoacromial

113
Q

Structures piercing medial intermuscular septum

A

Ulna nerve
Superior ulnar collateral artery

114
Q

Fulcrum of movement at costo clavicular joint

A

Costoclavicular ligament

115
Q

Unipennate muscles forearm

A

Extensor digitorum
Flexor pollicis longus

116
Q

Blood supply pec major

A

Pectoral branch thoracoacromial artery

117
Q

Deepest muscular plane palm

A

Adductor compartment

118
Q

Axillary sheath extension of

A

Cervical fascia

119
Q

Nerve supply to skin axilla

A

Intercostobrachial nerve
T2 second intercostal nerve

120
Q

OK sign muscles and innervation

A

FPL FDP
anterior IO

121
Q

Radioulnar joint types

A

Pivot joints
(Like atlantoaxial)

Part 1 Anatomy (9 decks)

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