Upper limb Flashcards
How many carpal bones are there?
8
How many metacarpals are there?
5
How many phalanges are there?
14
What is the origin and insertion of the deltoid muscle?
Origin: Lateral third of the clavicle and the spine of the scapula Insertion: Deltoid tuberosity of the humerus
What movement do they posterior fibres of the deltoid muscle allow?
Extension of the shoulder
What movement do they middle fibres of the deltoid muscle allow?
Abduction of the shoulder
What movement do the anterior fibres of the deltoid muscle allow?
Flexion of the shoulder
Name the muscles present in the anterior compartment of the arm
- Biceps brachi 2. Branchialis 3. Coacobrachialis
What nerve supplies the biceps, the branchialis and the coracobrachialis muscles?
Musculocutaneous
What is the purpose of the muscles of the anterior compartment of the arm?
Flexion of the elbow and flexion of the shoulder
In what compartment does the triceps muscle lie?
Posterior compartment of the arm
What is the function of the triceps muscle?
Extension of the elbow and extension of the shoulder
What nerve innervates the triceps muscle?
Radial nerve
What additional movement can the biceps muscle also perform apart from flexion?
Supination
What is the origin of the short head of the biceps branchii?
Tip of coracoid process of scapula
What is the origin of the long head of the biceps brachii?
Supraglenoid tubercle of the scapula/glenoid fossa
What is the insertion of the biceps muscle?
Radial tubersosity and fascia of forearm
What is the origin of the coracobrachialis muscle?
Tip of the coracoid process of the scapula
What is the insertion of the coracobrachialis muscle?
Middle third of medial surface of the humerus
What is the origin of the brachialis muscle?
Distal half of the anterior surface of the humerus
What is the insertion of the brachialis muscle?
Coronoid process and tuberosity ulna
What aspect of the elbow does the triceps muscle span?
Posterior aspect
What is the origins(s) of the triceps brachii muscle?
Long head: Infraglenoid tubercle of scapula Lateral head: Posterior surface of the humerous, superior to radial groove Medial head: Posterior surface of the humerous, inferior to radial groove
What kind of muscle is the triceps brachii?
Fusiform muscle
What are the two main superficial veins of the upper limb?
Cephalic vein and basillic vein
Where do the cephalic and basillic veins originate?
From the dorsal venous network (in the subcutaneous tissue of the dorsum of the hand)
Describe the usual course of the cephalic vein?
Ascends from the lateral aspect of the dorsal venous network up the lateral aspect of the forearm. The cephalic vein then communicates with the median cubital vein in the cubital fossa (in the anterior aspect of the elbow) and joins with the basillic vein. The cephalic vein then continues its course superiorly between the deltoid and pectoral muscle(along the delto pectoral groove). It enters the deltopectoral triangle. The cephalic vein then drains into the axillary vein.
Describe the course of venous blood from the axillary vein to the heart.
Subclavian which then drains into the braciocephalic which then drains into the SVC and into the right atrium
What is the communication between the cephalic and basillic veins?
The median cubital vein
Describe the course of the basilic vein
The basilic vein ascends from the subcutaneous tissue from the medial end of the dorsal venous network along the medial aspect of the forearm and teh inferior part of the arm. It then passs deeply, piercing the deep brachial fascia and running superior parallel to the brachial artery and the medial cutaneous nerve. It then merges with the accompining veins and into the axillary artery.
What is the common vein that all the veins form the upper limb ultimately drain into?
The subclavian vein
What vein in very often used for venopuncture in the forearm?
The median cubital vein.
What is the main action that the muscles of the anterior compartment of the forarm carry out?
Flexion and pronation
What neve are most of the muscles in the anterior compartment of the forarm supllied by? What other nerve supplies 1.5 of the muscles?
Median nerve. Ulnar nerve supllies one and a half.
What is the main action of the muscles in the posterior compartment of the forearm?
Extensors and supinators
What nerve suplies all the muscle in the posterior compartment of the foreamr?
Radial nerve
What are the two groups of muscle which move the joints in the hand?
- Forearm muscle whose muscle bellies are in the anterior and posterior compartments of the forearm and whose sital tensdons insert onto the bones of the hand
- Intrinsic hand muscles whose bellies and tendon insertions lie completely within the hand itself.
What are the four rotator cuff muscles?
Sapraspinatus
Infraspinatus
Teres minor
Subscapular
What are the nerve roots that come together to form the brachial plexus?
C5, C6, C7, C8, T1
What are the names nerves of the brachial plexus?
Musculocutaneous
Radial
Ulnar
Median
Axillary
What do the named nerves of the brachial plexus do?
- Carry somatic motor fibres to the skeletal muscles of the upper limb
- Carry somatic sensory fibres rom the skin of the upper limb to the smooth muscle of all the arterioles in the upper limb, the erector pili muscles and the sweat glands
What does the musculocutaneous nerve supply?
The muscles of the anterior arm
What does the median nerve supply?
Most of the muscles of the anterior forearm and thenar eminane(thumb) muscles
What does the ulnar nerve supply?
Most of the hand muscles (not the thumb and 1.5 muscles f the anterior forearm)
What does the axilliary nerve supply?
Deltoid muscle
What does the radial nerve supply?
Muscles of the posterior arm and posterior forearm.
What doe the term “end arteries” mean? What drug do you have to be very carfeful with in theses areas?
An artery that is the only blood supply to an area of tissue. Seen in the digits. Have to very careful with use of aadrenaline
What course the superficial lymphatic vessels follow in the upper limb?
They accompany the cephalic and basillic veins in the forarm
Where do the lymphatic vessels that accompany the basillic vein drain through?
The cubital nodes (anterior to the medial epicondyle)
Where do the cubital nodes drain?
Into the humeral (lateral) axillary nodes)
Ultimately, where do lymph vessels fromt the upper limb go?
They follow the subclavian vein to drain into the venous system at the venous angle
What course do the deep lymphatic vessels follow?
They accompany the deep veins (those alongside the radial, ulnar and brachial arteris) to the humeral (lateral) axilliary nodes
Where does the superior appendicular skeleton articulate with the axial skeleton?
Sternoclavicular joint
Which bony feature of the scapula is said to stick out like a “crows beak”?
Coracoid process
What is the area of the sscapula above the spine of the scapula called?
The supraspinous fossa
What is the area below the spine of the scapula called?
The infraspinous fossa
What does the acromium of the sternum articulate with?
The acromial end of the clavicle
What happens at the glenoid cavity?
It receives and articulates with the head of the humerus at the glenohumeral (shoulder) joint.
What does the concave costal surface of most of the scapula form?
The subscapular fossa
What is the differencebetween the acromial process and the acromial end?
The acromial process is on the scapula and describes a bony feature. The acromial end is on the clavicle and describes the area of articulation to the scapula.
What does the head of the humerus articulate with?
The glenoid cavity of the scapula
Where on the humerus does the deltoid muscle attach?
Deltoid tuberosity
What is another name for the bicipital groove and where would you find it?
The intertubecular sulcus. In between the greater and lesser tubercles of teh humerus.
What is the function intertubeculal groove/bicipital sulcus?
Provides a protected passage between the greater and lesser tubercles that allows the slendor tendon of the biceps muscle to pas through
What does the radial grrove do and where does it lie?
It is the groove for the radial nerve and it lies posteriorly on the humerus, in an oblique plane.
What does the coronoid fossa do?
Receives the coronoid process of the ulna during full flexion of the elbow
What does the radial fossa do?
Accomodates the edge of the head of the radius when the forearm is fully flexed.
Which of the forearm bones is longer?
The ulna
Which is the stabilizing bone of the forearm?
The ulna
Which forearm bone is medial and which is lateral?
Ulna is medial and radius in lateral
Where would you find the olecranon and what is its function?
Projecting from the posterior aspect of the ulna (forming the point of the elbow) It serves as a shor lever for extension of the elbow.
Does the ulna participate in the wrost joint?
No, only the radius does
What two bones does the radius articulate with?
The humerus and the ulna
Where on the ulna does the radius articulate?
The radial notch of the ulna
What does the olecranon fossa on the humerus do?
Articulate with the olecranon of the ulna during full extension of the elbow
Name all the parts of the condyle of the humerus
Radial fossa
Coronoid fossa
Capitlum
Trochlea
What are the two articular surfaces on the condyle of the humerus?
A leteral capitulum and a medial trochlea
What does the capitulum of the humerus do?
Articulates with the head of the radius
What does the trochlea do?
Articulates with the head of the ulna
Which is the shorter of the forearm bones?
The radius
What is the difference between the shaft of the radius and the shaft of the ulna?
The shaft of the radius enlarges as you follow it distally but the shaft of the ulna decreases in size
What does the ulnar notch do?
Accomodates the head of the ulna
What is the different between the phalynxes in the fingers and thumb?
The thumb only has a proximal and distal phaylnx wheneras the other phalanges have a proximal, middle and distal
What separates the anterior and posterior compartments of the arm?
The ntermuscular septum, which is continuous with the deep fascia of the upper arm
Which is the most superficial muscle of he anterior compartment of the arm?
Biceps brachii muscle
Where does the long head of the biceps brachii muscle run?
Through the intertrabecular groove on the humerus
Where doe sthe corocobrachialis muscle lie in relation to the biceps brachii muscle?
Deep to it
Where does teh coracobrachialis lie in relation to the biceps brachii?
Deep
What head of the triceps brachii muscle is the most superficial?
Lateral head
Where does the tendon of the triceps brachii insert?
The olecranon of the ulna bone
What four muscles move the pectoral girdle?
What muscles form the deltopectroal groove?
What are the two origins of the pectoralis major muscle?
What is the insertion of the pectoralis major muscle?
Lateral lip of the intertubercular sulcus of the humerus
Wht muscles define the anterior and posterior walls of the axilla?
Pectoralis major (anterior)
Pectoralis minor (posterior)
What is the muscle which allows us to do a “pull up”?
What is the main artery that supplies the upper limb?
What two muscles gaurd the nerves C5, 6, 7,8 and T1?
Anterior and middle scalene muscles
Where do the artery and vein run in relation to the anterior scalene muscle?
Veins runs in front and artery runs behind
What muscle does the cephalic vein run underneath before it drains into the subclavian vein?
Pectoralis minor
What nerve supplies the auraspinatus and infraspinatous muscles? From where does it arise?
Suprascapular nerve, arising from upper trunk
What does the dorasl scapular nerve supply?
The rhomboid muscles. (Major and minor)
From where does the long throacic nerve arise?
What does the long throacic nerve supply?
What nerve supplies the trapezius muscle?
The spinal accessory nerve
What supllis the levator scapuli muscle?
Roots of C3, 4 and 5
Describe the brachial plexus
- The five roots are the anterior rami of the nerves C5, 6, 7, 8 and T1
- These roots then merge to give three trunks; superior (C5 & 6), middle (C7) and inferior (C8 & T1)
- Each trunk then splits into two (anterior and posterior) to give 6 divisions
- The 6 divisions then regroup to become 3 cords, named on their relation to the axillary artery
- The branches then emerge from these cords
Describe the arrangement of the three cords in the brachial plexus
The posterior cord is formed from the three posterior divisions of the trunks (C5-C8,T1)
The lateral cord is the anterior divisions from the upper and middle trunks (C5-C7)
The medial cord is simply a continuation of the anterior division of the lower trunk (C8,T1)
What nerve are you testing when you test the biceps jerk reflex?
C5
What nerve root are you testing when you check the triceps reflex?
C7
What nerve supplies lattisimus dorse?
Thoracodorsal nerve
