Upper Limb 2 Flashcards
What are the 3 important muscles of the anterior arm?
What nerve supplies these muscles?
Biceps bracii
Coracobrachialis
Brachialis
Musculocutaneous nerve
What is the origin and insertion of the biceps bracii?
Long head:
- Supraglenoid tubercle of the scapula
- Radial tuberosity
Short head:
- Coracoid process
- Radial tuberosity
What 3 joints does the biceps bracii act on?
Shoulder
Elbow
Radio-ulnar joints
What two muscles arise from the coracoid process?
Short head of the biceps bracii
Coracobrachialis
What groove does the long head of the biceps bracii run in after arising from the supraglenoid tubercle?
Bicipital groove
What is the action of the biceps bracii at each of its joints?
Flexes shoulder and elbow joint
Supination of the radio-ulnar joint
Which segmental fibres mainly innervate biceps bracii?
C5 and C6
From which cord of the brachial plexus is the musculocutaneous nerve a branch of?
Lateral cord
What is the origin and insertion of the coracobrachialis?
Tip of the coracoid process
Medial margin of the humerus about its middle
What is the action of the coracobrachialis on the shoulder joint?
Flexion and adduction
What is the nerve supply of the coracobrachialis?
Musculocutaneous nerve
What is the origin and insertion of the brachialis?
Arises from the front of the distal half of the shaft of the humerus
Inserted into coronoid process of ulna
What is the main action of the brachialis on the elbow joint?
Flexes elbow in all positions
What nerve supplies the brachialis muscle?
Musculocutaneous nerve
What muscle does the musculocutaneous nerve perforate to enter the arm?
Coracobracialis
Between which two muscles does the musculocutaneous nerve descend between?
Biceps bracii
Brachialis
After supplying the muscles of the arm what does the musculocutaneous nerve continue as?
Lateral cutaneous nerve of the forearm
What is the segmental or root value of the musculocutaneous nerve?
C5-C7
Injury to the musculocutaneous nerve from a weapon such as a knife would result in what?
Paralysis of biceps bracii, coracobrachialis and brachialis
Loss of sensation on the lateral aspect of forearm
Where does the brachial artery start and end?
Direct continuation of the axillary artery which begins at the lower border of teres major muscle and ends in the cubital fossa close to the neck of the radius dividing into radial and ulnar arteries
What is the deep artery of the arm called?
Which artery gives it off as a branch?
Profunda brachii
Main branch given off by the brachial artery in the arm
Where is the best place to compress the brachial artery to control haemorrhage?
Middle of the arm/ middle third
The median nerve arises in the axilla by two roots from the brachial plexus.
What are these?
One from medial cord and one from the lateral cord of the brachial plexus
Describe the route of the median nerve in the arm once it is formed
Descends along the lateral side of axillary artery and upper part of brachial artery.
At the middle part of the arm the nerve crosses to the medial side of brachial artery and enters the cubital fossa.
Gives no branches in the axilla or the upper arm
What does the median nerve supply?
Muscles in anterior compartment of forearm (apart from flexor carpi ulnaris and ulnar half of flexor digitorum profundus)
What cord of the brachial plexus does the ulnar nerve arise from?
Medial cord of the brachial plexus
What is the route of the ulnar nerve in the arm once it arises?
Descends along the medial side of brachial artery and then it enters the posterior compartment of arm through the medial intermuscular septum runs along the medial head of triceps and to the back of the medial epicondyle
What muscles does the ulnar nerve supply?
Flexor carpi ulnaris and ulnar half of flexor digitorum profundus
Most intrinsic muscles of hand
What are the 3 common sites of humerus where 3 nerves could be damaged due to fracture?
Radial nerve -> radial groove
Ulnar nerve -> medial epicondyle
Axillary nerve -> surgical neck
What is the cubital fossa?
Triangular depression or a hollow in front of the elbow
Corresponds to the popliteal fossa at the back of the knee
What makes up the borders of the cubital fossa?
Base -> imagery line between two epicondyles
Medial border -> pronator teres muscle
Lateral border -> brachioradialis muscle
List some of the contents of the cubital fossa
Bifurcation of the brachial artery Deep accompanying veins Biceps bracii tendon Median nerve Radial nerve dividing into superficial and deep branches
What is usually the vein of choice for intravenous injections?
Median cubital vein
What is the origin and insertion of the triceps?
Long head:
- Infragenoid tubercle of the Scapula
- Olecranon process of the ulna
Lateral and medial heads:
- Humerus
- Olecranon process of the ulna
What is the main action of the triceps on the elbow joint?
Extension
What is the action of the anconeus muscle on the elbow joint?
Assists triceps in extending elbow joint;
Stabilises elbow joint;
Abducts ulna during pronation
What is the action to triceps and anconeus muscle?
Radial nerve
What does the radial nerve supply?
Extensor compartment of arm and forearm
Innervates all the extensor muscles of elbow and wrist joint
What is the route of the radial nerve once it arises?
Enters the arm anterior to the long head of triceps and runs along with the profunda femoris artery (deep artery of the arm) a main branch of the brachial artery and curves around the midshaft region of the humerus in the radial groove
What is the segmental (root value) of the radial nerve?
C5-T1
What is the characteristic clinical sign of radial nerve injury?
Wrist drop
What type of synovial joint is the elbow joint?
Synovial hinge
The fibrous layer of the joint capsule of the elbow joint is thickened on the medial and lateral aspect of the joint to form strong bands called what?
Is this the same with the anterior and posterior aspects?
Why?
Collateral ligament
Capsule is loose both on the anterior and posterior aspect of the joint to allow movement
Which ligament holds the head of the radius?
Anular ligament
What are the flexors of the elbow joint?
Brachialis
Biceps bracii
Brachioradialis
What are the extensors of the elbow joint?
Triceps bracii
Anconeus
Friction subcutaneous olecranon bursitis is also called what?
Why?
Students elbow
Students sitting at desk all day
What type of synovial joint are the radio-ulnar joints?
Pivot type synovial joints
What are the muscles involved in supination at the radio-ulnar joints?
Main
- Supinator
- Biceps bracii
Other muscles assisting:
- Extensor pollicis longus
- Extensor carpi radialis longus
What are the muscles involved in pronation at the radio-ulnar joints?
Main
- Pronator teres
- Pronator quadratus
Other muscles assisting:
- Flexor carpi radialis
- Palmaris longus
- Brachioradialis
What is the most powerful supinator of the forearm?
Biceps bracii
Which muscle is the most powerful pronator of the forearm?
Pronator teres