Upper Limb Flashcards

1
Q

The scapula overlies which ribs on the posterolateral aspect of the thorax?

A

R 2-7 (pg 36)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which nerve is at risk for damage with a fracture of the surgical neck of the humerus?

A

the axillary nerve (pg 38)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which type of fractures of the humerus might damage the radial nerve?

A

Transverse and spiral fractures (pg 38)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How might a an intercondylar fracture occur, and what nerves are at risk for damage?

A

Fall on a flexed elbow. Median or ulnar nn. (pg 38)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a Colles fracture?

A

Complete fracture of the distal 2cm of the radius (pg 39)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the clavicle weakest?

A

Between the middle and lateral thirds (pg 36)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the visible signs of a broken clavicle?

A

The SCM m. elevates the medial portion of the clavicle, and the trapezius m. is unable to hold up the lateral fragment, so the shoulder drops. (pg 36)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a dinner fork deformity a result of?

A

Posterior angulation in the forearm just proximal to the wrist, due to displacement of the radius. (pg 39)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the proximal carpal bones?

A

Scaphoid, lunate, triquetrum and pisiform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the distal carpal bones?

A

Trapezium, trapezoid, capitate and hamate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common fracture resulting from a fall on an open hand?

A

A fracture of the scaphoid at the scaphoid tubercle. (pg 40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why might avascular necrosis occur with a fracture of the scaphoid?

A

The bone tissue may die because of poor blood supply to the bone. (pg 40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the head of a metacarpal articulate with?

A

Base of proximal phalanges (pg 41)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How many phalanges does each digit have?

A

3 (proximal, middle and distal) for digits 2 - 5, but only two for the thumb (proximal and distal). (pg 41)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What joint represents the only articulation between the upper limb and the axial skeleton?

A

The sternoclavicular joint. (pg 41)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The sternoclavicular joint is what type of joint?

A

Saddle-type that functions as a ball-and-socket. (pg 41)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the function of the costoclavicular ligament?

A

It anchors the inferior surface of the sternal end of the clavicle to the 1st rib and its costal cartilage. (pg 41)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What ligaments serve to strengthen the sternoclavicular joint?

A

The anterior and posterior sternoclavicular ligaments, the interclavicular ligament and the costoclavicular ligament. (pgs 41-42)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the rotator cuff muscles?

A

Supraspinatus, infraspinatus, teres minor and subscapularis muscles. (pg 43)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the glenoid labrum?

A

A ring-like fibrocartilaginous lip that serves to deepen the glenoid fossa. (pg 43)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What motion is permitted by the glenohumeral joint?

A

Flexion, extension, medial and lateral rotation, abduction, adduction and circumduction. (pg 43)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the scapulohumeral muscles?

A

Deltoid, teres major, teres minor, supraspinatus, infraspinatus and subscapularis. (pg 44)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Where does the biceps brachii attach to the humerus?

A

There is no humeral attachment. (pg 62)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 3 joints the biceps brachii acts on?

A

Primarily the elbow and proximal radio-ulnar joints, but also the glenohumeral. (pg 62)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the borders of the quadrangular space?

A

Superior - teres minor;
Inferior - teres major;
Lateral - humerus;
Medial - long head triceps brachii

(pg 48)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is found in the quadrangular space?

A

Axillary n. and posterior humeral circumflex a. (pg 48)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the borders of the triangular space?

A

Base - long head triceps brachii;
Superior - teres minor;
Inferior - teres major (pg 49)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is found in the triangular space?

A

The circumflex scapular a. (pg 49)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the borders of the triangular interval?

A

Base - teres major;
Medial - long head triceps brachii;
Lateral - lateral head triceps brachii (pg 49)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is found in the triangular interval?

A

The radial n. and profunda brachii a. (pg 49)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What passes through the spinoglenoid notch?

A

Suprascapular a. (pg 47)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which arteries participate in the scapular anastamoses?

A

Suprascapular, dorsal scapular and circumflex scapular aa. (circumflex scapular is the key player) (pgs 47 - 48)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the common causes of injury to the axillary n.?

A

Fracture of surgical neck, dislocation of the glenohumeral joint, compression due to improper use of crutches and intramuscular injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the signs of damage to the axillary n.?

A

Atrophy of the deltoid m. (shoulder flattens and slight hollow appears inferior to acromion); loss of sensation over lateral part of proximal arm; impaired abduction of humerus from 15-90 degrees (pg 49)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most common cause of a rotator cuff injury?

A

Continual use of the limb in a position above horizontal. (pg 49)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which rotator cuff muscle is the most commonly injured?

A

Supraspinatus m. (pg 49)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Under what circumstances would allow for good collateral circulation to develop at the scapular anastamosis?

A

Slow occlusions due to disease. (pg 56)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the anterior axioappendicular muscles?

A

Pectoralis major, pectoralis minor, subclavius and serratus anterior. (pgs. 50-52)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is found in the deltopectoral groove?

A

The cephalic v. (pg 50)

40
Q

What are the borders of the deltopectoral triangle?

A

Superiorly - clavicle; Medially - pectoralis major; Laterally - deltoid (pg 50)

41
Q

What is found in the deltopectoral triangle?

A

Cephalic v., tip of coracoid process and branches of the thoracoacromial trunk (pg 50)

42
Q

What branches from the first part of the axillary artery?

A

Superior or supreme thoracic a. (pg 55)

43
Q

What are the boundaries of the first part of the axillary artery?

A

From the lateral border of R1 to the medial border of pectoralis minor. (pg 55)

44
Q

What is the axillary artery a continuation of, and what does it become?

A

Continuation of the subclavian a. and becomes the brachial a. (pg 55)

45
Q

What branches from the 2nd part of the axillary artery?

A

The thoracoacromial trunk and the lateral thoracic artery. (pg 55)

46
Q

What are the branches of the thoracoacromial trunk?

A

Clavicular, acromial, deltoid and pectoral (pg 55)

47
Q

What branches from the third part of the axillary artery?

A

Subscapular artery and the anterior and posterior humeral circumflex aa. (pg 55)

48
Q

What are the borders of the second part of the axillary artery?

A

The medial and lateral borders of pectoralis minor. (pg 55)

49
Q

What are the borders of the third part of the axillary artery?

A

The lateral border of pectoralis minor to the inferior border of teres major. (pg 55)

50
Q

Where does the axillary vein form, and what does it form from?

A

From the brachial and basilic vv. at the inferior border of teres major. (pg 56)

51
Q

Where do the pectoral lymph nodes receive lymph from?

A

Anterior thoracic wall and breast. (pg 56)

52
Q

Where do the subscapular lymph nodes receive lymph from?

A

Posterior thoracic wall and scapular region. (pg 56)

53
Q

Where do the humeral lymph nodes receive lymph from?

A

All lymph from upper limb with the exception of vessels following the cephalic v. (pg 57)

54
Q

Where are the central lymph nodes found, and from where do they receive lymph?

A

Found deep to pectoralis minor and receive lymph from the pectoral, subscapular and humeral nodes. (pg 57)

55
Q

Where do apical lymph nodes receive lymph from?

A

From all groups of axillary nodes and the nodes accompanying the cephalic v. (pg 57)

56
Q

What does the left subclavian lymphatic trunk commonly join, and where does it drain?

A

It joins the thoracic duct, which drains to the left venous angle. (pg 57)

57
Q

What does the subclavian lymphatic trunk unite with to form the right lymphatic duct?

A

Either the jugular or the bronchomediastinal trunks. (pg 57)

58
Q

What forms the brachial plexus?

A

Ventral primary rami of C5-C8 and T1. (pg 57)

59
Q

Roots C5 and C6 innervate what?

A

Muscles that act at the shoulder or flex the elbow. (pg 57)

60
Q

What forms the superior trunk?

A

C5 and C6 roots, sometimes C4. (pg 58)

61
Q

What forms the middle trunk?

A

C7 (pg 58)

62
Q

What forms the inferior trunk?

A

C8 and T1 roots, sometimes T2. (pg 58)

63
Q

What does the anterior division of the brachial plexus supply?

A

The flexor compartment of the upper limb. (pg 58)

64
Q

What does the posterior division of the brachial plexus supply?

A

Extensor compartments of the upper limb. (pg 58)

65
Q

What forms the lateral cord of the brachial plexus?

A

Anterior divisions of the superior and middle trunks. (pg 58)

66
Q

What is the medial cord of the brachial plexus a continuation of?

A

The anterior division of the inferior trunk. (pg 58)

67
Q

What forms the posterior cord of the brachial plexus?

A

Posterior divisions of all 3 trunks (superior, middle and inferior). (pg 58)

68
Q

Which nerves branch directly from roots?

A

The dorsal scapular n. (C5) and the long thoracic n. (C5-C7) (pg 58)

69
Q

What is the most powerful forearm supinator?

A

Biceps brachii (pg 63)

70
Q

Which nerves branch directly from trunks?

A

Suprascapular n. and nerve to subclavius. (pg 58)

71
Q

Which nerves branch from the lateral cord?

A

Lateral pectoral n., musculocutaneous n. and lateral root of median n. (pg 58)

72
Q

Which nerves branch from the medial cord?

A

Medial root of median n., medial pectoral, medial brachial cutaneous, medial antebrachial cutaneous and ulnar nn. (pg 59)

73
Q

Which nerves branch from the posterior cord?

A

Upper subscapular, thoracodorsal, lower subscapular, axillary and radial nn. (pg 59)

74
Q

Which nerve roots are damaged in a case of shoulder dystocia?

A

C5 and C6 nerve roots. (pg 59)

75
Q

Which muscles are paralyzed with Erb-Duchenne palsy?

A

Deltoid, biceps brachii and brachialis mm. (pg 59)

76
Q

What are the physical signs of damage to nerve roots C5 and C6?

A

Adducted upper limb, medially rotated arm and extended elbow (waiter’s tip position). (pg 59)

77
Q

The cords of the brachial plexus named for their relation to what?

A

The 2nd part of the axillary artery. (pg 58)

78
Q

What is Klumpke palsy?

A

Injury to inferior trunk (C8-T1) of the brachial plexus. (pg 60)

79
Q

What are the signs of damage to nerve roots C8 to T1?

A

Claw hand as a result of unopposed action of extensors and flexor digitorum mm. (pg 60)

80
Q

Where would sensory loss be experienced as a result of Klumpke palsy?

A

Medial part of dorsum of hand (dorsal branch of ulnar nerve) and medial 1 and a half digits and palmar surface of hand (palmar and palmar digital branches of ulnar n.). (pg 60)

81
Q

What movements occur at the elbow joint?

A

Flexion, extension, supination and pronation. (pg 60)

82
Q

Which muscles make up the anterior group of the arm?

A

Biceps brachii, brachialis and coracobrachialis. (pg 60)

83
Q

What is the posterior group of the arm comprised of?

A

Triceps brachii m. (pg 60)

84
Q

What type of movement is permitted by the humeroulnar joint?

A

Flexion and extension (hing joint). (pg 61)

85
Q

What type of joint is the humeroradial joint, and what movement is permitted?

A

Limited ball and socket hinge-type joint, allows flexion, extension, supination and pronation. (pg 61)

86
Q

What are the 3 parts of the ulnar collateral ligament?

A

Anterior, posterior and inferior (oblique) bands. (pg 61)

87
Q

What articulates at the humeroulnar joint?

A

The trochlea of the humerus and the trochlear notch of the ulna. (pg 61)

88
Q

What are the two fossae that allow for flexion at the elbow?

A

The coronoid fossa of the humerus and the radial fossa of the humerus. (pg 61)

89
Q

What articulates at the humeroradial joint?

A

The capitulum of the humerus and the head of the radius. (pg 61)

90
Q

Where is the anular ligament found, and what is its function?

A

Encircling the head of the radius, and it permits pronation and supination of forearm. (pg 61)

91
Q

What does the radial collateral ligament connect?

A

The lateral epicondyle to the annular ligament. (pg 61)

92
Q

What are the bursae of the elbow joint?

A

Intratendinous, subtendinous and subcutaneous olecranon bursae. (pg 61)

93
Q

What is “student’s elbow”?

A

Subcutaneous olecranon bursitis, due to excessive pressure and friction on the bursa. (pg 61)

94
Q

What nerve is at risk for damage with elbow dislocation, and what would be the signs of nerve damage?

A

The ulnar nerve. Signs of injury would be numbness of little finger and weakness of flexion and ulnar deviation at wrist. (pg 61)

95
Q

What are the common causes of elbow dislocation?

A

Fall on hands when elbow is flexed, hyperextension or a blow that drives the ulna posterior and posterolateral. (pg 61)