Upper Limb Flashcards
What forms the roots of the brachial plexus?
Anterior rami of spinal nerves C5-T1
Which muscles do the roots of the brachial plexus pass through to reach the arm?
Anterior and medial scalene muscles
Describe the trunks of the brachial plexus
Superior - C5, C6
Middle - C7
Inferior - C8, T1
What are the nerve roots of the musculocutaneous nerve?
C5-7
What are the motor functions of the musculocutaeneous nerve?
Innervates brachialis, biceps brachii and coracobrachialis
What are the sensory functions of the musculocutaeneous nerve?
Innervates the skin of the lateral anterior forearm and lateral posterior forearm via the lateral cutaneous branch
What are the nerve roots of the axillary nerve?
C5-6
What are the motor functions of the axillary nerve?
Innervates teres minor and deltoid
What are the nerve roots of the median nerve?
C6-T1
What are the motor functions of the median nerve?
Flexor muscles of forearm
Thenar muscles
Two lateral lumbricals
What are the motor functions of the radial nerve?
Innervates triceps brachii and the posterior compartment of the forearm
What are the nerve roots of the radial nerve?
C5-T1
What are the sensory functions of the radial nerve?
Innervates the posterior aspect of the arm and forearm and the posterolateral aspect of the hand
What are the nerve roots of the ulnar nerve?
C8-T1
What are the motor functions of the ulnar nerve?
Innervates the intrinsic muscles of the hand, flexi carpi ulnaris and the medial half of flexor digitorum produndus
Which bone possesses the glenoid fossa?
Scapula
Which muscle is responsible for the first 15 degrees of shoulder abduction?
Supraspinatus
Which pathology causes a painful arc?
Supraspinatus tendinitis
Which rotator cuff muscles attach to the greater tuberosity?
Supraspinatus
Infraspinatus
Teres minor
Which rotator cuff muscle attaches to the lesser tuberosity?
Subscapularis
Which groove does the long head of biceps brachii run through?
Intertubercular sulcus
Which important structures are at risk in a fracture of the surgical neck of humerus?
Axillary nerve
Posterior circumflex artery
Which important structures are at risk in a humeral shaft fracture?
Radial nerve
Profunda brachii artery
Which important structures are at risk in a supracondylar fracture of the humerus?
Brachial artery
Anterior interosseous nerve
What are the attachments of pectoralis major?
Medial clavicle
Anterior sternum
Intertubercular sulcus of humerus
What are the attachments of pectoralis minor?
3rd-5th ribs
Coracoid process of scapula
Which nerve supplies serratus anterior?
Long thoracic nerve
Which muscle anchors and depresses the clavicle?
Subclavius
Damage to which nerve causes winging of the scapula?
Long thoracic nerve
What are the borders of the axilla?
Lateral - intertubercular groove of the humerus
Medial - Serratus anterior and thoracic wall
Anterior - Pectoralis major
Posterior - Subscapularis, teres major and latissimus dorsi
List the contents of the axilla
Axillary artery
Axillary vein
Brachial plexus
Axillary lymph nodes
Biceps brachii (short head)
Coracobrachialis
What is the quadrangular space?
Gap in the posterior wall of axilla that the axillary nerve and posterior circumflex humeral artery pass through to the posterior arm
What is the clavipectoral triangle?
Opening in the anterior wall of the axilla
Cephalic vein enters axilla here and the medial and lateral pectoral nerves leave
Which nerve is most at risk during axillary clearance?
Long thoracic
What are the borders of the triangular interval?
Superior - inferior border of teres major
Lateral - shaft of humerus and lateral head of triceps brachii
Medial - lateral border of the long head of triceps brachii
Which structures pass through the triangular interval?
Radial nerve
Profunda brachii artery
What are the borders of the triangular space?
Lateral - medial margin of the long head of triceps brachii
Inferior - superior margin of teres major
Superior - inferior border of teres minor
Which structures pass through the triangular space?
Circumflex scapular artery and vein
Which nerve supplies the trapezius?
Accessory nerve
Which nerve supplies latissimus dorsi?
Thoracodorsal nerve
What are the actions of the rhomboid muscles of the back?
Retract and rotate the scapula
Which nerve supplies teres major?
Lower subscapular nerve
Which muscles does the axillary nerve innervate?
Deltoid
Teres minor
Which nerve supplies the ‘regimental badge area’?
Upper lateral cutaneous nerve of the arm
Where does the axillary nerve lie in relation to the axillary artery?
Posterior
What are the functions of the biceps brachii?
Forearm supination
Elbow and shoulder flexion
Which spinal cord segment does the biceps reflex test?
C5, C6
What are the attachments of coracobrachialis?
Coranoid process of scapula
Medial humeral shaft
Which arm muscle forms the floor of the ACF?
Brachialis
What are the attachments of brachialis?
Humeral shaft
Ulnar tuberosity
What does ‘popeye sign’ suggest?
Rupture of biceps tendon
Which artery supplies the posterior compartment of the arm?
Profunda brachii artery
Which nerve innervates triceps brachii?
Radial nerve
Which spinal segment does the triceps tendon reflex test?
C7, T1
What are the borders of the antecubital fossa?
Lateral - brachioradialis
Medial - pronator teres
Superior - line between epicondyles of humerus
Roof - bicipital aponeurosis
Floor - brachialis, supinator
What are the contents of the antecubital fossa? (lateral to medial)
Radial nerve
Biceps tendon
Brachial artery
Median nerve
What is Volkmann’s ischaemic contracture?
Uncontrolled flexion of the hand
It is caused by damage to the brachial artery - often supracondylar fracture
Which nerve is tested by asking the patient to make an OK sign?
Anterior interosseous nerve
Name a vein that is a common site for venepuncture in the arm
Median cubital vein
What does the proximal ulna articulate with?
Trochlea of humerus
Which muscle attaches to the olecranon of the ulna?
Triceps brachii
What is Monteggia’s fracture?
Fracture of proximal shaft of ulna
Dislocation of radial head at elbow
What is Galeazzi’s fracture?
Distal radius fracture
Dislocation of ulnar head at the distal radio-ulnar joint
Which muscle attaches to the radial tuberosity?
Biceps brachii muscle
Which carpal bones does the radius articulate with?
Scaphoid
Lunate
What is a Colle’s fracture?
Distal radius fracture with posterior (dorsal) displacement of hand and wrist
What is a Smith’s fracture?
Distal radius fracture with anterior (volar) displacement of the hand and wrist
Which articular surfaces are involved in the proximal radio-ulnar joint?
Radial head
Radial notch of ulna
Which articular surfaces are involved in the distal radio-ulnar joint?
Ulnar notch of radius
Ulnar head
Which structure prevents the ulna from articulating with the carpal bones?
Articular disc
What type of synovial joint is the wrist joint?
Ellipsoidal (condyloid)
Why is the scaphoid at risk of avascular necrosis?
Retrograde blood supply which enters distally
Where do the superficial forearm muscles collectively attach proximally?
Medial epicondyle
Which two structures pass between the two heads of flexor digitorum superficialis?
Median nerve
Ulnar artery
Where does flexor digitorum superficialis attach distally?
Base of the middle phalanx of the four digits
Where does flexor digitorum profundus attach distally?
Base of the distal phalanx of the four digits
Which muscle flexes the distal IP joints?
Flexor digitorum profundus
Which branch of the median nerve innervates the deep layer of muscles in the anterior forearm?
Anterior interosseous nerve
Which structure passes betweenthe two heads of supinator?
Radial nerve
Which nerve supplies the thenar muscles?
Recurrent branch of the median nerve
Why is the palm of the hand spared in carpal tunnel syndrome?
It is supplies by the palmar cutaneous branch of the median nerve which does not travel through the carpal tunnel
Which muscles in the hand does the median nerve supply?
Thenar muscles
Lateral two lumbricals
Which muscles in the anterior forearm are supplied by the ulnar nerve?
Flexor carpi ulnaris
Medial half of flexor digitorum profundus
Which carpal bone is formed within the tendon of flexor carpi ulnaris?
Pisiform
What is a Boxer’s fracture?
Fracture of the 5th metacarpal neck
What is Bennett’s fracture?
Fracture of the 1st metacarpal base
What are the borders of the anatomical snuffbox?
Medial - tendon of extensor pollicis longus
Lateral - tendons of extensor pollicis brevis and abductor pollicis longus
Proximal - styloid process of the radius
What are the contents of the anatomical snuff box?
Radial artery
Superficial branch of the radial nerve
Cephalic vein
Where do the lumbricals originate from?
Tendon of flexor digitorum profundus
What is the action of palmaris brevis?
Deepens the curvature of the hand
Where does the axillary artery become the brachial artery?
Lower border of teres major
Which artery travels with the radial nerve in the radial groove of the humerus and supplies the structures in the posterior aspect of the upper arm?
Profunda brachii
Which structures are found within the axillary sheath?
Axillary artery and the 3 cords of the brachial plexus
At which landmark is the subclavian artery renamed the axillary artery?
Lateral border of the clavicle
