Upper Limb Flashcards

1
Q

Pectoralis Major attachments

A

clavicle, sturnum, first 6 costal cartilages –> intertubercular sulcus of humerus

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2
Q

Pect Major innervation

A

Lateral (C5, C6, C7) and medial (C8, T1) pectoral nerve

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3
Q

Pect Major actions

A

adducts and medially rotates shoulder joint

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4
Q

Pectoralis minor attachments

A

3rd-5th costal cartilages to coracoid process of scapula

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5
Q

Pect. Minor innervation

A

medial pectoral nerve (C8,T1)

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6
Q

Pect. Minor action

A

stabilizes scapula drawing it against thoracic wall

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7
Q

Subclavius attachments

A

1st rib and costal cart to inferior surface clavicle

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8
Q

Subclavius innervation

A

subclavian nerve (C5, C6)

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9
Q

Subclavius actions

A

anchors and depresses clavicle

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10
Q

Serratus anterior attachments

A

lateral 1st-8th ribs to anterior surface of scapula

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11
Q

Serratus anterior innervation

A

Long thoracic nerve (C5, C6, C7)

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12
Q

Serratus anterior actions

A

Holds scapula against thoracic wall. Rotates scapula.

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13
Q

Four rotator cuff muscles

A

supraspinatus, infraspinatus, teres minor, subscapularis

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14
Q

Deltoid attachments

A

clavicle, acromion and spine of scapula to deltoid tuberosity of humerus

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15
Q

Deltoid innervation

A

Axillary nerve (C5, C6)

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16
Q

Deltoid actions

A

Flexes, extends, abducts, medially and laterally rotates shoulder joint

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17
Q

Supraspinatus attachments

A

supraspinous fossa of scapula to greater tubercle of humerus

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18
Q

Supraspinatus actions

A

initiates and assists deltoid in abduction (first 15 degrees)

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19
Q

Supraspinatus Innervation

A

Suprascapular nerve (C4, C5, C6)

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20
Q

Infraspinatus attachments

A

infraspinous fossa of scapula to greater tubercle of humerus

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21
Q

Infraspinatus actions

A

Laterally rotate shoulder joint

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22
Q

Infraspinatus innervation

A

Suprascapular nerve (C5, C6)

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23
Q

Teres Minor attachments

A

lateral border scapula to greater tubercle of humerus

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24
Q

Teres Minor actions

A

laterally rotate shoulder joint

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25
Q

Teres Minor Innervation

A

Axillary Nerve (C5, C6)

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26
Q

Teres Major attachments

A

Lateral border and inferior angle of scapula to medial lip of intertubercular sulcus of humerus

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27
Q

Teres Major actions

A

adducts and medially rotates shoulder

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28
Q

Teres Major innervation

A

Lower subscapular nerve (C5, C6)

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29
Q

Subscapularis attachments

A

subscapular fossa to lesser tubercle of humerus

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30
Q

Subscapularis actions

A

adducts and medially rotates shoulder

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31
Q

Subscapularis innervation

A

Upper and Lower subscapular nerves (C5, C6, C7)

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32
Q

Biceps Brachii attachments

A

Short head: coracoid process
Long head: supraglenoid tubercle of scapula
to tuberosity of radius and fascia of forearm

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33
Q

Biceps Brachii actions

A

Most Powerful Supinator Forearm, (drive screw into hard wood) flex elbow when arm supinated, flexes shoulder

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34
Q

Biceps Brachii innervation

A

Musculocutaneous Nerve (C5, C6)

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35
Q

Brachialis attachments

A

anterior surface humerus to coronoid process and tuberosity of ulna

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36
Q

Brachialis actions

A

Flexes elbow joint in all positions; Chief Flexor

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37
Q

Brachialis innervation

A

Musculocutaneous nerve (C5, C6)

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38
Q

Coracobrachialis attachments

A

coracoid process, medial surface humerus

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39
Q

Coracobrachialis actions

A

helps flex and adduct shoulder, stabilizes glenohumeral joint

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40
Q

Coracobrachialis innervation

A

Musculocutaneous nerve (C5, C6, C7)

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41
Q

Triceps brachii attachments

A

Long head: infraglenoid tubercle of scapula
Lateral: posterior surface humerus, sup to radial groove
Medial: post surface humerus inferior to radial groove
to olecranon of ulna and fascia of forearm

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42
Q

Triceps brachii innervation

A

Radial nerve (C6, C7, C8)

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43
Q

Triceps brachii actions

A

CHIEF EXTENSOR

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44
Q

Aconeus attachments

A

lateral epicondyle humerus to olecranon and superior posterior surface ulna

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45
Q

Aconeus actions

A

assists in extending elbow

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46
Q

Aconeus innervation

A

Radial nerve (C7, C8, T1)

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47
Q

Superior thoracic artery origin

A

First part of axillary artery

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48
Q

Superior thoracic artery course

A

passes b/t pect major and minor; supplies 1st and 2nd intercostal spaces and superior part of serratus anterior

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49
Q

Thoraco-acromial artery origin

A

Second part Axillary artery

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50
Q

Thoraco-acromial artery course

A

Pierces costocoracoid membrane. Divides into four branches: pectoral, deltoid, acromial and clavicular

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51
Q

Thoraco-acromial branches

A

Acromial, Clavicular, Pectoral, Deltoid (Akron City Police Department)

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52
Q

Lateral Thoracic Artery origin

A

second part axillary artery

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53
Q

Lateral Thoracic Artery course

A

descends axillary border of pect minor, follows into thoracic wall supplying lateral aspect of breast

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54
Q

Anterior circumflex humeral artery origin

A

third part axillary artery

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55
Q

Posterior circumflex humeral artery origin

A

third part axillary artery

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56
Q

Circumflex humeral artery (anterior and posterior) course

A

Encircle surgical neck of humerus, anastomosing; large posterior branch goes to quandrangular space

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57
Q

Subscapular artery origin

A

third part of axillary artery

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58
Q

Subscapular artery course

A

descends from inferior border subscapularis, along lateral border of scapula dividing into circumflex scapular and thoracodorsal arteries

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59
Q

Subscapular artery branches

A

Circumflex scapular artery

Thoracodorsal artery

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60
Q

Circumflex scapular artery origin

A

Subscapular artery

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61
Q

Circumflex scapular artery course

A

curves around lateral border of scapula to enter infraspinous fossa. anastomosing with suprascapular artery

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62
Q

Thoracodorsal artery origin

A

Subscapular artery

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63
Q

Thoracodorsal artery course

A

Continues subscap course; descending with thoracodorsal nerve to enter apex of latissimus dorsi

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64
Q

Profunda brachii artery origin

A

brachial artery near middle of arm

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65
Q

Profunda brachii artery course

A

accompanies radial nerve along radial groove of humerus; supplies posterior compartment of arm and anastomoses around elbow

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66
Q

Superior ulnar collateral artery origin

A

Brachial artery near middle of arm

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67
Q

Superior ulnar collateral artery course

A

accompanies ulnar nerve to posterior aspect of elbow; anastomoses with posterior ulnar recurrent artery

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68
Q

Inferior ulnar collateral artery origin

A

brachial artery superior to medial epicondyle of humerus

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69
Q

Inferior ulnar collateral artery course

A

passes anterior to medial epicondyle of humerus to anastomose with anterior ulnar recurrent artery

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70
Q

Dorsal scapular nerve origin

A

C5 and frequently C4

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71
Q

Dorsal scapular nerve innervates

A

Rhomboids, occasionally levator scapulae

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72
Q

Long thoracic nerve origin

A

C5, C6, C7

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73
Q

Long thoracic nerve innervates

A

Serratus anterior

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74
Q

Suprascapular nerve origin

A

C5, C6

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75
Q

Suprascapular nerve innervates

A

Supraspinatus and infraspinatus muscles; glenohumeral joint

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76
Q

Subclavian nerve origin

A

C5, C6

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77
Q

Subclavian nerve innervates

A

Subclavius and sternoclavicular joint

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78
Q

Lateral pectoral nerve origin

A

lateral cord; C5, C6, C7

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79
Q

Lateral pectoral nerve innervates

A

Pectoralis major

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80
Q

Musculocutaneous nerve origin

A

Lateral cord; C5-C7

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81
Q

Musculocutaneous nerve innervates

A

Arm’s anterior compartment muscles: coracobrachialis, biceps brachii, brachialis, and skin of lateral aspect of forearm

82
Q

Median nerve origin

A

Lateral root from lateral cord (C6, C7) and medial root of medial cord (C8, T1)

83
Q

Median nerve innervates

A

muscles of anterior forearm compartment, intrinsic muscles in thenar half of palm and palmar skin

84
Q

Medial pectoral nerve origin

A

Medial cord, C8, T1

85
Q

Medial pectoral nerve innervates

A

Pectoralis minor and pectoralis major

86
Q

Medial cutaneous nerve of arm origin

A

medial cord; C8, T1

87
Q

Medial cutaneous nerve of arm innervates

A

skin of medial side of arm to medial epicondyle of humerus and olecranon of ulna

88
Q

Median cutaneous nerve of forearm origin

A

Medial cord, C8, T1

89
Q

Median cutaneous nerve of forearm innervates

A

skin of medial side of forearm, as far distal as wrist

90
Q

Ulnar nerve origin

A

medial cord; (often C7), C8, T1

91
Q

Ulnar nerve innervates

A

flexor carpi ulnaris and ulnar half of flexor digitorum profundus; most intrinsic muscles of hand; skin of hand medial to axial line

92
Q

Upper subscapular nerve origin

A

posterior cord; C5

93
Q

Upper subscapular nerve innervates

A

superior portion of subscapularis

94
Q

Lower subscapular nerve origin

A

Posterior cord; C6

95
Q

Lower subscapular nerve innervates

A

inferior portion of subscapularis and teres major

96
Q

Thoracodorsal nerve origin

A

posterior cord; C6, C7, C8

97
Q

Thoracodorsal nerve innervates

A

Latissimus dorsi

98
Q

Axillary nerve origin

A

Posterior cord; C5, C6

99
Q

Axillary nerve innervates

A

Genohumeral joint, teres minor, deltoid, skin of superolateral arm (over inferior part of deltoid)

100
Q

Radial nerve origin

A

posterior cord; C5-T1 (largest branch of plexus

101
Q

Radial nerve innervates

A

All muscles of posterior compartments of arm and forearm; skin of posterior and inferolateral arm, posterior forearm, and dorsum of hand lateral to axial line of digit 4

102
Q

C3 & C4 Dermatome

A

Base of neck extending laterally over shoulder

103
Q

C5 Dermatome

A

Superior aspect of abducted limb

104
Q

C6 Dermatome

A

Forearm laterally and thumb

105
Q

C7 Dermatome

A

Middle and ring finger & middle of posterior surface of limb

106
Q

C8 Dermatome

A

little finger, medial side of hand and forearm (inferior aspect of abducted limb

107
Q

T1 Dermatome

A

middle of the forearm to the axilla

108
Q

T2 Dermatome

A

small part of the arm and skin of axilla

109
Q

Radial Nerve Test

A

Motor: strength of elbow, wrist & finger extension against resistance (while arm abducted)
Sensory: dorsal webbing between MC 1&2

110
Q

Radial Nerve Compression Etiology

A

“Saturday Night Palsy”/ “Crutch Palsy”

prolonged axillary compression

111
Q

Bones of Hand

A

Scaphoid, Lunate, Triquetrum, Pisiform, Trapezium, Trapezoid, Capitate, Hamate

112
Q

Posterior cutaneous nerve of the arm

A

(C5-C8) branch of the radial nerve; supplies skin on posterior surface of arm

113
Q

Posterior cutaneous nerve of forearm

A

(C5-C8) branch of radial nerve; supplies skin on posterior surface of forearm

114
Q

Superior lateral cutaneous nerve of the arm

A

(C5, C6) terminal branch of axillary nerve; supplies skin over lower part of deltoid and lateral side of midarm

115
Q

Inferior lateral cutaneous nerve of arm

A

(C5, C6) branch of radial nerve; supplies skin over the inferolateral aspect of arm. Frequently a branch of the posterior cutaneous nerve of the forearm

116
Q

Lateral cutaneous nerve of the forearm

A

(C6, C7) terminal branch of musculocutaneous nerve; supplies skin on the lateral side of forearm

117
Q

Medial cutaneous nerve of the arm

A

(C8-T2) arises from the medial cord, often uniting with lateral cutaneous branch of 2nd intercostal nerve. Supplies skin on the medial side of the arm

118
Q

Medial cutaneous nerve of the forearm

A

(C8, T1) arises from the medial cord of brachial plexus and supplies the skin on the anterior and medial surfaces of the forearm

119
Q

Supraclavicular nerves

A

supplyh the skin over the clavicle and superolateral aspect of the pec major

120
Q

Brachial artery course

A

begins at inferior border of teres major, ends in cubital fossa opposite the neck of hte radius under cover of the bicipital aponeurosis. Divides into radial and ulnar arteries

121
Q

Cubital Fossa boundaries

A

Superior: between medial and lateral epicondyles
Medial: Pronator Teres
Lateral: brachioradialis
Floor: brachialis and supinator muscles
Roof: brachial and antebrachial (deep) fascia, reinforced by the bicipital aponeurosis

122
Q

Cubital Fossa Contents

A

terminal part of brachial artery/ radial and ulnar artery branches
Deep accompanying veins of the arteries
Biceps brachii tendon
Median nerve
Radial nerve, dividing into superficial and deep branches

123
Q

Flexor-Pronator muscles of the forearm

A
Superficial:
Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris (FCU)
Intermediate:
Flexor digitorun superficialis (FDS)
Deep:
Flexor digitorum profundus (FDP)
Flexor pollicis Longus (FPL)
Pronator quadratus
124
Q

Common flexor tendon

A

Attaches superficial and intermediate layer of flexor-pronator muscles of the forearm to the medial epicondyle of the humerus (the common flexor origin)

125
Q

Pronator teres attachments

A

Prox: coronoid process of ulna, medial epicondyle of humerous
Dist: middle of convexity of lateral surface of radius

126
Q

Pronator teres innervation

A

Median nerve (C6, C7)

127
Q

Pronator teres action

A

Pronates and flexes forearm

128
Q

Flexor carpi radialis attachments

A

Prox: medial epicondyle of humerus
Dist: base of 2nd/3rd metacarpal

129
Q

Flexor carpi radialis innervation

A

Median nerve (C6, C7)

130
Q

Flexor carpi radialis actions

A

flexes and abducts hand at wrist

131
Q

Palmaris longus attachments

A

Prox: medial epicondyle of humerus
Dist: distal 1/2 of flexor retinaculum, palmar aponeurosis

132
Q

Palmaris longus innervation

A

Median nerve (C7, C8)

133
Q

Palmaris longus action

A

Flexes hand at wrist and tenses palmar aponeurosis

134
Q

Flexor carpi ulnaris attachments

A

Prox: olecranon and post. border of ulna
Dist: Pisiform, hook of hamate, 5th metacarpal

135
Q

Flexor carpi ulnaris innervation

A

Ulnar nerve (C7, C8)

136
Q

Flexor carpi ulnaris action

A

Flexes and adducts hand at wrist

137
Q

Flexor digitorum superficialis attachments

A

Prox: medial epicondyle of humerus and coronoid process of ulna, oblique line of radius
Dist: bodies of middle phalanges of medial four digits

138
Q

Flexor digitorum superficialis innervation

A

Median nerve (C7-T1)

139
Q

Flexor digitorum superficialis action

A

flexes wrist joint. Flexes interphalangeal joints and metacarpophalangeal joints

140
Q

Flexor digitorum profundus attachments

A

Prox: medial and anterior surfaces of ulna and interosseous membrane
Dist: bases of distal phalanges 2nd-5th digits

141
Q

Flexor digitorum profundus innervation

A

Median (C8, T1) and Ulnar (C8, T1) Nerve

142
Q

Flexor digitorum profundus action

A

Flexes wrist joint. Flexes distal interphalangeal joints

143
Q

Flexor pollicis longus attachments

A

Prox: anterior surface radius, interosseous membrane
Dist: base of distal phalanx of thumb

144
Q

Flexor pollicis longus innervation

A

Anterior interosseous nerve, from median nerve (C8, T1)

145
Q

Flexor pollicis longus action

A

flexes wrist. flexes metacarpophalangeal and interphalangeal joints of thumb

146
Q

Pronator quadratus attachments

A

Prox: anterior surface ulna
Dist: anterior surface radius

147
Q

Pronator quadratus innervation

A

Anterior interosseous nerve from median nerve (C8, T1)

148
Q

Pronator quadratus actions

A

pronates forearm

149
Q

Brachioradialis attachments

A

Prox: lateral supraepicondylar ridge humerus
Dist: Radius near styloid process

150
Q

Brachioradialis innervation

A

Radial nerve (C5, C6, C7)

151
Q

Brachioradialis action

A

flexion of elbow when arm pronated

152
Q

Extensor carpi radialis longus attachment

A

Prox: lateral supra-epicondylar ridge of humerus
Dist: dorsal base of 2nd metacarpal

153
Q

Extensor carpi radialis longus innervation

A

Radial nerve (C6, C7)

154
Q

Extensor carpi radialis longus action

A

Extend and abduct wrist

155
Q

Extensor carpi radialis brevis attachment

A

Prox: lateral epicondyle of humerus (common extensor origin)
Dist: Dorsal base 3rd metacarpal

156
Q

Extensor carpi radialis brevis innervation

A

Deep branch of radial nerve (C7, C8)

157
Q

Extensor carpi radialis brevis action

A

extend and abduct wrist joint

158
Q

Extensor digitorum attachments

A

Prox: Lateral epicondyle of humerus
Dist: extensor expansions of middle 4 fingers

159
Q

Extensor digitorum innervation

A

Posterior interosseous nerve (C7, C8)

[continuation of deep branch of radial nerve]

160
Q

Extensor digitorum actions

A

extend wrist joint, medial four fingers at metacarpophalangeal joints

161
Q

Extensor digiti minimi attachments

A

Prox: Lateral epicondyle of humerus
Dist: extensor expansion of 5th digit

162
Q

Extensor digiti minimi innervation

A

Posterior interosseous nerve (C7, C8)

163
Q

Extensor digiti minimi action

A

Extends wrist joint, 5th finger at metacarpophalangeal joint

164
Q

Extensor carpi ulnaris attachments

A

Prox: lateral epicondyle of humerus, posterior border of ulna
Dist: doprsal base of 5th metacarpal

165
Q

Extensor carpi ulnaris innervation

A

Posterior interosseous nerve (C7, C8)

166
Q

Extensor carpi ulnaris action

A

Extends and adducts wrist joint; also active during clenching

167
Q

Supinator attachments

A

Prox: lateral epicondyle of humerus,
Dist: lateral, posterior and anterior surfaces of radius

168
Q

Supinator innervation

A

Deep branch of radial nerve (C7, C8)

169
Q

Supinator action

A

Supinates forearm; rotates radius

170
Q

Abductor pollicis longus attachments

A

Prox: posterior surface of ulna, radius, interosseous membrane
Dist: base of 1st metacarpal

171
Q

Abductor pollicis longus innervation

A

Posterior interosseous nerve (C7, C8)

172
Q

Abductor pollicis longus action

A

Extends wrist, abducts and extends thumb

173
Q

Extensor pollicis longus attachments

A

Prox: Posterior surface of ulna and interosseous membrane
Dist: dorsal base of distal phalanx of thumb

174
Q

Extensor pollicis longus innervation

A

Posterior interosseous nerve (C7, C8)

175
Q

Extensor pollicis longus action

A

extends wrist joint, extends distal phalanx of thumb

176
Q

Extensor pollicis brevis attachments

A

Prox: posterior surface of radius and interosseous membrane
Dist: dorsal base of proximal phalanx of thumb

177
Q

Extensor pollicis brevis innervation

A

Posterior interosseous nerve (C7, C8)

178
Q

Extensor pollicis brevis action

A

Extends wrist joint, extends proximal phalanx of thumb

179
Q

Extensor indicis attachment

A

Prox: Posterior surface of ulna and interosseous membrane
Dist: extensor expansion of 2nd finger

180
Q

Extensor indicis innervation

A

Posterior interosseous nerve (C7, C8)

181
Q

Extensor indicis actions

A

Extends wrist joint, extends 2nd finger (enabling its independent extension)

182
Q

Opponens pollicis attachments

A

Prox: flexor retinaculum and tubercles of scaphoid and trapezium
Dist: Lateral side of 1st metacarpal

183
Q

Opponens pollicis innervation

A

Recurrent branch of median nerve (C8, T1)

184
Q

Opponens pollicis action

A

oppose thumb by drawing 1st metacarpal to center of palm and rotating it medially

185
Q

Abductor pollicis brevis attachments

A

Prox: flexor retinaculum and tubercles of scaphoid and trapezium
Dist: lateral side of base of proximal phalanx of thumb

186
Q

Abductor pollicis brevis innervation

A

Recurrent branch of median nerve (C8, T1)

187
Q

Abductor pollicis brevis action

A

abducts thumb, helps oppose it

188
Q

Flexor pollicis brevis attachments

A

Prox: flexor retinaculum and tubercles of scaphoid and trapezium
Dist: lateral side of base of proximal phalanx of thumb

189
Q

Flexor pollicis brevis innervation

A

Recurrent branch of median nerve (C8, T1)

190
Q

Flexor pollicis brevis action

A

Flexes thumb

191
Q

Adductor pollicis attachments (Transverse and Oblique heads)

A

Prox: bases of 2nd and 3rd metacarpals, capitate, ant surface of shaft 3rd metacarp
Dist: medial base of proximal phalanx of thumb

192
Q

Adductor pollicis innervation

A

Deep branch of ulnar nerve (C8, T1)

193
Q

Adductor pollicis actions

A

Adducts thumb toward lateral border of palm

194
Q

Abductor Digiti Minimi

A

O: Pisiform
I: Base of Prox phalanx of 5th digit
N: Deep Branch Ulnar N (C8-T1)
A: Ulnar a.

Abducts 5th digit

195
Q

Flexor Digiti Minimi Brevis

A

O: Flexor retinaculum & hook of hamate
I: base of prox phalanx 5th digit
N: Deep branch ulnar N (C8-T1)
A: ulnar a.

Flexes proximal phalanx of little finger

196
Q

Opponens Digiti Minimi

A

O: Flexor retinaculum & hook of hamate
I: Medial side 5th metacarpal
N: Deep branch ulnar N (C8-T1)
A: ulnar a.

Opposes little finger

197
Q

Lumbricals (1/2)

A

O: Lateral tendons of flexor digitorum profundus
I: extensor expansion radial side of proximal phalanx digits 2-3
N: Median N (C8-T1)
A: Superficial palmar arch

Flex MP joints, extend the proximal and distal IP joints of digits 2-3

198
Q

Lumbricals (3/4)

A

O: Medial 3 tendons of flexor digitorum profundus
I: Extensor expansion radial side of proximal phalanx digits 4-5
N: Deep Ulnar (C8-T1)
A: Superficial palmar arch

Flex MP joints, extend the proximal and distal IP joints digits 4-5

199
Q

Dorsal Interosseous Muscles

A
4 Bipennate muscles
O: Adjacent sides of metacarpal bones
I: Lateral sides bases of proximal phalanges, Extensor expansion
N: Deep branch of Ulnar N (C8-T1)
A: Dorsal and palmar metacarpal a

Abducts finger, flex MP joints, extend IP joints
DAB!

200
Q

Palmar Interosseous Muscles

A

3 Unipennate muscles
O: Medial side 2nd metacarpal, lateral sides 4th and 5th metacarpals
I: bases of proximal phalanges on same side as origin, extensor expansions
N: Deep branch ulnar n.
A: Palmar metacarpal a.

Adducts fingers, flex MP joints, extend IP joints
PAD

201
Q

Palmaris Brevis

A

O: medial side of flexor retinaculum, palmar aponeurosis
I: skin of medial side of palm
N: superficial branch ulnar nerve (C8-T1)
A: ulnar a.

Wrinkles skin on medial side of palm