Upper Limb Flashcards

0
Q

Name the two major superficial veins of the upper limb. Both these superficial veins originate distally at what structure? These superficial veins communicate again in the cubital fossa via what structure?

A

Cepalic and basilic, originate in dorsal venous network of hand, median cubital vein.

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1
Q

Name the muscles that arise from the vertebral column and connect the upper limb to the trunk. Which of these muscles is not innervated by a branch off the brachial plexus?

A

1) Trapezius ** (CN XI not from brachial plexus)
2) Levator Scapulae
3) Rhomboid major
4) Rhomboid minor
5) Latissimus dorse

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2
Q

Name the muscles arising from the thoracic wall that connect the upper limb to the trunk. Which is deepest?

A

1) Pectoralis major
2) Pectoralis minor
3) Serratus anterior ** deepest
4) Subclavius
5) Sternocleidomastoid

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3
Q

For what two nerves is the pectoralis minor a landmark? Why is the nomenclature of these nerves reversed with regard to the anatomical
location?

A

Medial and lateral pectoral nerves. The nomenclature is related to the cord from which they arise off the brachial plexus, not their relationship to the pectoralis minor.

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4
Q

Name the muscles of the scapular region. Which of the muscles of the scapular region is not a rotator cuff muscle?

A

1) Subscapularis
2) Supraspinatus
3) Infraspinatus
4) Teres minor
5) Teres major ** Not rotator cufff

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5
Q

What is the function of the rotator cuff?

A

They apply the head of the humerus to the shallow glenoid cavity of the glenohumeral joint.

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6
Q

Which aspect of the shoulder joint is not reinforced by these muscles and what is the clinical significance of this?

A

The inferior aspect, so shoulder dislocation occurs inferiorly and then pops up anteriorly.

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7
Q

What structures pass through the quadrangular space? What are the boundaries?

A

The axillary nerve and the posterior circumflex artery. The boundaries: Teres minor, teres major, long head of triceps, humerus

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8
Q

What structures pass through the triangular space?
What are its boundaries?

A

the radial nerve and the profunda brachial artery.. the teres major, long head of tricep brachii, humerus

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9
Q

Which muscles form the various walls of the axilla; medial, anterior, and posterior.

A

Medial: serratus anterior and intercostal muscles
Anterior: pectoralis major, pectoralis minor, subclavius
Posterior: subscapularis, teres major, latissimus dorsi

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10
Q

At what anatomical landmark does the subclavian artery become the axillary artery?

A

The lateral edge of the 1st rib

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11
Q

What anatomical structure serves as a landmark to define the three divisions of the axillary artery?

A

The pectoralis minor

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12
Q

Name the branches off each of the three parts of the axillary artery.

A

1st: superior thoracic a.
2nd: thoracocromial a. and lateral thoracic a.
3rd: subscapular a., anterior and posterior circumflex humeral aa.

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13
Q

At what anatomical landmark does the axillary artery become the brachial artery?

A

The lower border of the teres major

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14
Q

The arm consists of two distinct compartments. Name them.
What two fascial structures define these two compartments

A

The anterior (flexor) compartment and the posterior (extensor) compartment.

The lateral and medial intermuscular septae define them.

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15
Q

Be able to list the action and innervation of each muscle in these two compartments. (anterior and posterior)

A

Flexors- Coracobrachialis, biceps brachii, brachialis (Musculocutaneous n.)

Extensors- triceps brachii (radial n.)

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16
Q

In the flexor compartment of the arm which muscles cross the elbow joint? How does this attachment affect the action of these muscles?

A

Biceps brachii & brachialis. in addition to flexing the elbow the biceps is a powerful supinator.

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17
Q

How does the brachial artery terminate?
Where does this termination occur with relation to the cubital fossa?

A

The radial and ulnar arteries. The bifurcation occurs deep to the bicipital aponeurosis but superficial to the tendon of the biceps brachii.

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18
Q

Name the two muscles that form the lateral and medial boundaries of the cubital fossa.

A

Lateral- brachioradialis

Medial- pronator teres

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19
Q

Which of the three major nerves found passing from the arm into the forearm is not found within the cubital fossa?

A

ULNAR NERVE

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20
Q

Which muscles are found in the superficial group within the flexor compartment? Of these five muscles which is not innervated by the median nerve?

A

Lateral to medial

1) Pronator teres
2) Flexor carpi radialis
3) Palmaris longus
4) Flexor digitorum
5) Flexor carpi ulnaris *** innervated by ulnar not median n.

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21
Q

Name the muscles of the deep group of the flexor compartment.
What is the innervation of each of these muscles in this compartment?
Which muscle is located most medial?

A

Lateral to medial:

1) Flexor pollicis longus –> anterior interosseous br. of median n.
2) Flexor digitorum profundus –> medial- ulnar n. lateral- interosseous
3) Pronator quadratus –> anterior interosseous br. of median n.

Most medial is flexor digitorum profundus .. ??**

22
Q

Name the muscles in the superficial group of the extensor compartment. What is the innervation of each one?

A

1) Brachioradialis –> Radial n.
2) Extensor carpi radialis longus –> Radial n.
3) Extensor carpi radialis brevis
4) Extensor digitorum
5) Extensor digitorum minimi
6) Extensor carpi ulnaris

   The rest innervated by posterior interosseus deep br. of radial n
23
Q

Name the muscles of the deep group of the extensor compartment.
What is the innervation of each one?

A

1) Anconeus Radial n.
2) Supinator
3) Abductor pollicis longus
4) Extensor pollicis brevis
5) Extensor pollicis longus
6) Extensor indicis
ALL OTHERS BY Posterior INTEROSSEOUS DEEP BRANCH OF RADIAL N.

24
Q

Which vessel passes into the extensor compartment to supply the muscles?

A

The posterior interosseous artery

25
Q

What other artery pierces the interosseous membrane to assist in supplying these muscles.

A

The anterior interosseous artery.

26
Q

The dorsal carpal arch arises from which artery on the dorsal surface?
This artery passes through what anatomical region at the base of the thumb and then passes to the palmar surface to contribute to the formation of which arterial arch?

A

The anterior interosseous artery which has fused with the posterior interosseous artery just before this.

The anatomical snuff box ; forms the deep palmer arch.

27
Q

What structure forms the roof of the carpal tunnel?

A

The flexor retinaculum

28
Q

Which nerve is irritated in carpal tunnel syndrome?

A

The median nerve.

29
Q

Which nerve(s) supply the thenar muscles? List the three muscles in this group

A

The (recurrent branch) of the median nerve.

1) Abductor pollicis brevis
2) Flexor pollicis brevis
3) Opponens pollicis

30
Q

Which nerve(s) supply the hypothenar muscles? List the muscles in this group.

A

The deep branch of the ulnar nerve.

1) Abductor digiti minimi
2) Flexor digiti minimi
3) Opponens digiti minimi

31
Q

What is the functional significance of the tendons of the deep digital flexors piercing the tendons of the superficial digital flexors.

A

The tendons of the deep digital flexors extend out to attach distally to the terminal phalanges so they must pierce the tendon of the superficial digital flexors which attach proximally to the sides of the middle phalanges.

32
Q

Which two lumbricals are innervated by the median nerve?

A

The first and second lumbricals

33
Q

What nerve innervates the remaining lumbricals. Is this pattern consistent in the interossei? If not state their innervation.

A

The deep branch of the ulnar nerve. All interossei muscles are innervated by the deep branch of the ulnar nerve.

34
Q

Which artery is responsible for forming the majority of the superficial palmar arch?

A

Ulnar artery

35
Q

Which artery is responsible for forming the majority of the deep palmar arch?

A

Radial artery

36
Q

The deep palmar arch lies deep to which tendons of the hand?

A

Flexor digitorum profundus

The tendons of the long flexors muscles.

37
Q

What is the pectoral girdle?

A

An incomplete bony ring formed by the scapula the clavicle in the sternum.

38
Q

What is the main vessel that distributes blood to the upper limb?

A

The subclavian artery

39
Q

Where does the subclavian artery turn into the axillary artery? And then to the brachial artery? Into the ulnar and radial arteries?

A

When it passes over rib one, at Teres major, just below the elbow

40
Q

What blood vessels supply the scapular region, back of the arm, and posterior forearm?

A

subclavian and axillary aa., profunda brachii, posterior interosseous

41
Q

All superficial veins lie above what?

A

The deep investing Fascia of the upper limb

42
Q

What are the main superficial veins?

A

Dorsal and Palmar digital veins, basilic vein, cephalic vein, median cubital vein, median vein of the forearm

43
Q

What is the bicipital aponeurosis?

A

Layer of fascia arising from biceps brachii , forms floor under median cubital vein

44
Q

What supplies innervation to the skin over the shoulder?

A

Supraclavicular n. (C3,C4)

45
Q

What innervates the anterior flexor compartments?

A

Median
Musculocutaneous
Ulnar

46
Q

What supplies the posterior extensor compartments?

A

Axillary
Radial
Posterior interosseous

47
Q

Name the muscles of the pectoral region and the nerve that innervates each.

A

1) pectoralis major (lateral and medial pectoral nn.)
2) pectoralis minor (medial pectoral n.)
3) serratus anterior (long thoracic n)
4) subclavius (branch of brachial plexus)

48
Q

Action and attachment of serratus anterior

A

rotate scapula laterally, lower raised arm, draw the scapula forward in pushing and forward reaching movements

1st to the 9th ribs and insert onto the medial border of the scapula

49
Q

Attachment and action of Pectoralis major

A

Adduct arm, assists in medial rotation, connects axial to appendicular

the clavicular part originates from the medial half of the clavicle
the sternocostal part originates from the sternum and costal cartilages 1 to 6
the abdominal part originates from the anterior layer of the rectus sheath.
All three parts insert onto the crest of the greater tuberosity of humerus

50
Q

Attachment and action of pectoralis minor

A

Stabilize scapula, elevate ribs if scapula is fixed, draw scapula down

3rd to 5th ribs to coracoid process

51
Q

Attachment and action of subclavius

A

steady the clavicle

52
Q

What is the clavipectoral fascia?

A

thickening of deep fascia. it encloses the subclavius m. and fills gap as costocoacoid membrane. it is like a roof.