Upper Limb Flashcards
Name the major parts of the scapula.
- coracoid process, acromion, glenoid fossa, spine, supraspinatus fossa, infraspinatus foss
Name the major parts of the humerus.
- head, anatomical and surgical necks, greater tubercle, lesser tubercle, intertubercular groove, deltoid tuberosity, spinal groove
- radial groove, coronoid fossa (for ulna in full flexion), olecranon fossa (for ulna in full extension)
- medial and lateral epicondyles
- capitulum, trochlea
Name the major parts of the ulna.
- trochlear notch, olecranon process, coronoid process
- head of ulna (distal! vs. proximal head of radius), styloid process of ulna
Name the major parts of the radius.
- head of radius (proximal! vs. distal head of ulna)
- styloid process of radius
What holds the forearm bones together?
- ulna and radius are held together by the ligaments at each end and also by the interosseus membrane between them
Name the bones of the carpus (the wrist).
- wrist in supination, lateral to medial: Some Lovers Try Positions That They Can’t Handle
- proximal row (L to M): scaphoid, lunate, triquetrum, pisiform
- distal row (L to M): trapezium, trapezoid, capitate, hamate
What part of the metacarpals contains the head (the proximal or distal end)?
- the head of the metacarpals is found at the distal end
What are the major joints of the pectoral girdle? Which joint makes up the shoulder joint?
- sternoclavicular joint
- coracoclavicular joint
- acromioclavicular joint
- glenohumeral joint (shoulder joint)
What are the major ligaments of the pectoral girdle?
- coracoclavicular ligament (coronoid and trapezoid parts)
- coracoacromial ligament
- acromioclavicular ligament
What are the major ligaments of the shoulder joint?
- (there are MANY!)
- supraspinatus TENDON
- subscapularis TENDON
- capsular ligaments
In the elbow joint, what articulates with the humerus’ trochlea? With the humerus’ capitulum?
- trochlea: trochlear notch of ulna
- capitulum: radial head
What are the major ligaments of the elbow joint?
- anular ligament: from the ulna and wraps around the radial head
- radial and ulnar collateral ligaments
- joint capsule
What makes up the wrist joint?
- the distal end of the radius and the proximal row of the carpal bones
- (the ulnar is not directly involved, but it does have an articular disc at its head that contributes to the joint)
What are the major wrist ligaments?
- radial and ulnar collateral ligaments
- palmar radiocarpal ligament
- dorsal radiocarpal ligament
Where does the flexor retinaculum attach to? What is deep to it?
- (this is a ligamentous structure)
- it is attached to the scaphoid, pisiform, trapezium, and hamate carpal bones (these make up the four corners of the wrist!)
- deep to the flexor retinaculum is the carpal tunnel?
What passes through the carpal tunnel?
- the median nerve! (compression here leads to carpal tunnel syndrome)
- (the ulnar nerve, ulnar artery, and radial artery all pass outside the tunnel)
What are the major joints of the hand? What type of special joints are in the thumb?
- CMC joints: carpometacarpal joints
- MCP joints: metacarpophalangeal joints
- IP joints: interphalangeal joints (DIPs and PIPs)
- CMC joint of thumb: saddle joint
- MCP joint of thumb: ellipsoid joint
What are the pectoral girdle muscles? What is the origin and insertion of each?
- (these muscles mainly move the scapula)
- trapezius: occipital bone, ligamentum nuchae, T1-T12 (O); clavicle, acromion, scapular spine (I)
- serratus anterior: anterior aspect of ribs 1-8 (O); anterior medial border of scapula (I)
- pectoralis minor: anterior aspect of ribs 2-5 (O); coracoid process (I)
- rhomboid major: T1-T4 (O); posterior medial border of scapula (I)
- rhomboid minor: C7 (O); posterior medial border of scapula
- levator scapulae: C1-C4 (O); superior aspect of poster medial border of scapula (I)
- subclavius: rib 1 (O); clavicle (I)
Which nerves supply the muscles of the pectoral girdle?
- trapezius: CN XI (spinal part); NOT from the brachial plexus!
- serratus anterior: long thoracic nerve
- pectoralis minor: medial and lateral pectoral nerves
- rhomboids: dorsal scapular nerve
- levator scapula: dorsal scapular nerve
- subclavius: nerve to subclavius
Which muscles move the shoulder (not including the rotator cuff)?
- pectoralis major (adductor): medial clavicle, sternum, ribs 1-6 (O); bicipital groove of humerus (I)
- latissimus dorsi (adductor and extensor): T7-L5 (O); intertubercular groove of humerus (I)
- teres major (adductor and extensor): posterior aspect of inferior angle of scapula (O); intertubercular groove of humerus (I)
- deltoid: (abductor): clavicle and acromion (O); lateral aspect of humerus (I)
- coracobrachialis (flexor): coracoid process (O); medial 1/3 of humerus (I)
Which muscles make up the rotator cuff of the shoulder?
- (these muscles stabilize the shoulder; keeping the head of the humerus locked in; they all insert onto the tubercles of the humerus)
- subscapularis: anterior surface of scapula (O)
- supraspinatus: above the scapular spine (O)
- infraspinatus: below the scapular spine (O)
- teres minor: posterior aspect of inferior angle of scapula, above the teres major and below the infraspinatus (O)
Which nerves supply the muscles of the shoulder and the rotator cuff?
- pectoralis major: medial and lateral pectoral nerves
- lattisimus dorsi: thoracodorsal nerve
- teres major: lower subscapular nerve
- deltiod: axillary nerve
- corachobrachialis: musculocutaneous nerve
- subscapularis: subscapular nerves
- supraspinatus and infraspinatus: suprascapular nerve
- teres minor: axillary nerve
What are the muscles that make up the posterior compartment of the arm?
- (these mainly extend the arm)
- triceps brachii (long head): infraglenoid tubercle of scapula (O); olecranon process of ulna (I)
- triceps brachii (lateral head): upper end of humerus (O); olecranon process of ulna (I)
- triceps brachii (medial head): upper end of humerus (O); olecranon process of ulna (I) (lies deep to the other two heads)
- anconeus: lateral epicondyle of humerus (O); olecranon process of ulna (I)
Which nerves supply the muscles of the posterior compartment of the arm?
- the radial nerve
- (the raidal nerve supplies all posterior muscles of the arm and forearm!)
What are the muscles that make up the anterior compartment of the arm?
- (these are mainly flexors of the arm; biceps also supinate)
- biceps brachii (long head): supraglenoid tubercle of scapula (O); radial tuberosity (I)
- biceps brachii (short head): coracoid process of scapula (O); radial tuberosity (I)
- coracobrachialis: coracoid process (O); medial 1/3 of humerus (I)
- brachialis: anterior surface of distal humerus (O); coronoid process and tuberosity of ulna (I) (it lies deep to the biceps)
Which nerves supply the muscles of the anterior compartment of the arm?
- biceps brachii: musculocutaneous nerve
- coracobrachialis: musculocutaneous nerve
- brachialis: musculocutaneous nerve
- (musculocutaneous nerve supplies all muscles of the anterior arm - NOT the forearm)
What is the general grouping of the muscles of the forarm? What actions does each group perform?
- anteromedial group (anterior group); deep and superficial: flexion of wrist and fingers, pronation of forearm
- posterolateral group (posterior group); deep and superficial: extension of wrist and finger, supination of forearm
Which muscles make up the superficial layer of the anteromedial muscles of the forearm?
- (these are wrist and finger flexors, forearm pronators)
- they all originate from the MEDIAL epicondyle of the humerus (the common flexor tendon); from L to M:
- pronator teres (no flexor action): inserts onto the proximal radius
- flexor carpi radialis: inserts onto the palmar base of the 2nd metatarsal
- palmaris longus: inserts onto the palmar aponeurosis
- flexor carpi ulnaris: inserts onto the palmar base of the 5th metatarsal
- (remember “Pass, Fail, Pass, Fail”)
Which muscles make up the intermediate layer of the anteromedial muscles of the forearm?
- (this is a wrist and finger flexor)
- flexor digitorum superficialis: lateral epicondule of humerus, middle aspect of radius (O); palmar aspect of middle phalanges of lateral 4 fingers (I)
Which muscles make up the deep layer of the anteromedial muscles of the forearm?
- (these are wrist and finger flexors, forearm pronators) from L to M:
- flexor pollicis longus: distal radius (O); palmar aspect of distal phalanx of pollex (I)
- flexor digitorum profundus: ulnar, radius, interosseus membrane (O); palmar aspect of distal phalanges of lateral 4 fingers (I)
- pronator quadratus (no flexor action): medial ulna (O); lateral radius (I) (deepest muscle, wraps “around” the distal ulna and radius)
Which nerves supply the anteriomedial muscles of the forearm?
- all are supplied by the median nerve, EXCEPT for the flexor carpi ulnaris and the medial part of the flexor digitorum profundus
- these two are supplied by the ulnar nerve
Which muscles make up the superficial layer of the posterolateral muscles of the forearm?
- (these are wrist and finger extensors, forearm supinators)
- most originate from the LATERAL epicondyle of humerus (the common extensor tendon); from L to M:
- brachioradialis: inserts onto distal end of radius (*this is a FLEXOR, not an extensor, but lies in the lateral compartment)
- extensor carpi radialis longus: inserts onto the dorsal base of the 2nd metatarsal
- extensor carpi radialis brevis: inserts onto the dorsal base of the 3rd metatarsal
- extensor digitorum: inserts onto the dorsal aspect of distal phalanges of lateral 4 fingers
- extensor digiti minimi: inserts onto the dorsal aspect of proximal phalanx of little finer
- extensor carpi ulnaris: inserts onto the dorsal base of the 5th metatarsal
- anconeus (pronator, also elbow extensor): lateral epicondyle of humerus (O); olecranon process of ulna (I)
Which muscles make up the deep layer of the posterolateral muscles of the forearm?
- (these are wrist and finger extensors, forearm supinators) from L to M:
- supinator (superficial and deep parts)
- abductor pollicis longus: ulna, radius, interosseus membrane (O); 1st metacarpal (I)
- extensor pollicis brevis: radius, interosseus membrane (O); proximal phalanx of pollex (I)
- extensor pollicis longus: ulna, interosseus membrane (O); distal phalanx of pollex (I)
- extensor indicis: ulna, interosseus membrane (O); distal phalanx of index finger (I)
Which nerves supply the muscles of the posterolateral compartment of the forearm?
- all are supplied by the radial nerve
- (all posterior muscles of the arm and forearm are supplied by the radial nerve)
Briefly explain the blood supply to the upper limb.
- subclavian artery becomes the axillary artery , which gives off a deep brachial branch (supplies the posterior arm) before continuing down the arm as the brachial artery
- at the level of the cubital fossa, the brachial artery bifuricates into the radial and ulnar arteries
Which structures lie in the cubital fossa?
- from L to M:
- biceps tendon
- brachial artery (just before it bifuricates into radial and ulnar arteries)
- median nerve
Briefly explain the venous drainage of the upper limb.
- the cephalic vein starts at the lateral wrist, while the basilic vein starts at the medial wrist
- these extend upwards on their respective sides (there is a median cubital vein that attaches the (lateral) cephalic to the (medial) basilic) and eventually drain into the subclavian vein
- before this junction, the basilic vein gets joined by the brachial vein to form the axillary vein (so axillary vein and cephalic vein join to form the subclavian vein)
- (the brachial vein drains the posterior aspects)
What are the basic parts of the brachial plexus?
- “(Should’ve) Read That Damn Cadaver Book”
- 5 spinal roots: C5-T1
- 3 trunks: superior (from C5-C6), middle (from C7), inferior (from C8-T1)
- 6 divisons: 3 anterior, 3 posterior (each trunk gives off 1 of each)
- 3 cords: lateral, posterior, medial
- 5 (terminal) branches (L to M): musculocutaneous, axillary, radial, median, ulnar
What are the nerve branches of the superior trunk?
- “the 3 S’s of the Superior trunk”
- (1st S is from the Superior trunk)
- suprascapular nerve (C5,6)
- nerve to subclavius (C5,6)
What are the branches of the lateral cord?
- “LM(L)M”
- lateral pectoral (C5,6,7)
- musculocutaneous (C5,6,7)
- (lateral root) of median nerve ((C5-T1)
What are the branches of the posterior cord?
- “ULTRA”
- upper subscapular (C5,6)
- lower subscapular (C5,6)
- thoracodorsal (middle subscapular) (C6,7,8)
- radial (C5-T1)
- axillary (C5,6)
What are the branches of the medial cord?
- “M4U”
- medial pectoral (C8,T1)
- medial brachial cutaneous (T1)
- medial antebrachial cutaneous (C8,T1)
- (medial root) of median nerve (C5-T1)
- ulnar (C7-T1)
Where does the long thoracic nerve arise from? What about the dorsal scapular nerve?
- long thoracic: the spinal roots of C5, C6, and C7
- dorsal scapular: C5
Which muscles does the dorsal scapular nerve supply? The long thoracic nerve? Nerve to subclavius? Suprascapular nerve?
- dorsal scapular: levator scapulae and the rhomboids
- long thoracic: serratus anterior
- nerve to subclavius: subclavius
- suprascapular: supraspinatus, infraspinatus
Which muscles does the pectoralis nerves supply? The subscapular nerves? The thoracodorsal nerve?
- pectoralis: pectoralis major and minor
- subscapular: subscapularis, teres major
- thoracodorsal nerve: latissimus dorsi
Which muscles does the musculocutaneous nerve supply? The axillary nerve? Radial nerve? Median nerve? Ulnar nerve?
- musculocutaneous: muscles of the anterior arm (corachobrachialis, biceps brachii, brachialis)
- axillary: teres minor, deltoid
- radial: all poster muscles of arm and forearm
- median: all anterior muscles of the forearm except those supplied by the ulnar nerve
- ulnar: flexor carpi ulnaris, medial 1/2 of flexor digitorum profundus
