Upper Limb Flashcards
Muscles forming the ANTERIOR WALL of the AXILLA
PECTORALS MAJOR & PECTORALIS MINOR
Muscles forming the POSTERIOR WALL of the AXILLA
SCAPULA, SUBSCAPULARIS, TERES MAJOR & LATISSIMUS DORSI
Muscles forming the MEDIAL WALL of the AXILLA
THORACIC WALL & SERRATUS ANTERIOR
Muscles forming the LATERAL WALL of the AXILLA
INTERTUBERCULAR SULCUS OF HUMERUS
Contents of the axilla
Axillary artery, Axillary vein, Brachial plexus, Tendons of Biceps Brachii + Coracobrachialis & Axillary lymph nodes
Brachial plexus values
Formed by the ANTERIOR (ventral) RAMI of C5-T1
What root(s) of the brachial plexus give the superior trunk?
C5 + C6 roots
What root(s) of the brachial plexus give the middle trunk?
C7 root
What root(s) of the brachial plexus give the inferior trunk?
C8 + T1 roots
Which nerve root(s) are affected in Erb’s palsy?
C5 + C6 roots
What is Erb’s palsy?
Injury to UPPER trunk giving a MEDIALLY ROTATED UPPER TRUNK WITH FLEXED WRIST
What causes Erb’s palsy?
HYPEREXTENSION of the HEAD from the SHOULDER
Which muscles are affected in Erb’s palsy?
SUPRASPINATUS, INFRASPINATUS, SUBCLAVIAS, BICEPS BRACHII, BRACHIALIS, CORACOBRACHIALIS, DELTOID & TERES MINOR
What is Klumpke’s palsy?
Injury to LOWER trunk giving a loss of grasp reflex with a supinated hand, extended wrist and fingers clawed
Which nerve root(s) are affected in Klumpke’s palsy?
C8 + T1 roots
What causes Klumpke’s palsy?
Undue ABDUCTION of the ARM
Which muscles are affected in Klumpke’s palsy?
INTRINSIC MUSCLES OF THE HAND + ULNAR FLEXORS OF WRIST & FINGERS AFFECTED
What are the cords of the brachial plexus?
Lateral, posterior and medial **
What are the branches of the LATERAL CORD?
MUSCULOCUTANEOUS nerve (+ lateral pectoral and lateral root of median nerves)
What are the branches of POSTERIOR CORD?
AXILLARY & RADIAL nerves (+ thorascodorsal, upper subscapular and lower sub scapular nerves)
What are the branches of MEDIAL CORD?
ULNAR nerve (+medial pectoral, median root of median nerve, medial cutaneous nerves of arm and forearm)
Arterial supply of the Upper Limb
Brachiocephalic–>Subclavian–>Axillary–>Brachial–>Radial/Ulnar–>Deep palmar arch–> Superficial palmar arch
Name the superficial veins of the Upper Limb
Cephalic vein, Median cubital vein & Basilic veins
Which of the veins of the upper limb is most lateral?
Cephalic vein
Which of the veins of the upper limb is most medial?
Basilic vein
Which of the veins of the upper limb shunts blood from one of the other veins to another? From which to which?
Median Cubital vein shunts blood from Cephalic to Basilic
Area supplied by C3 dermatome
Tip of shoulder
Area supplied by C4 dermatome
Top half of shoulder
Area supplied by C5 dermatome
Lateral aspect of arm
Area supplied by C6 dermatome
Lateral aspect of forearm and thumb
Area supplied by C7 dermatome
Middle 3 fingers
Area supplied by C8 dermatome
Little finger
Area supplied by T1 dermatome
Medial aspect of elbow
Area supplied by T2 dermatome
Medial aspect of arm
What are the 5 groups of AXILLARY LYMPH NODES?
Anterior (pectoral), Posterior (subscapular), Apical, Central and Lateral groups
Pectoral girdle
Set of bones connecting the upper limb to the axial skeleton
Sterno-clavicular joint
Small, double plane synovial joint articulating entire upper limb and pectoral girdle
Acromio-clavicular joint
Plane synovial joint connecting acrimion of scapula and lacrimal end of clavicle
What causes movement of pectoral girdle?
Sterno-clavicular, acromio-clavicular and shoulder joints all moving simultaneously
Scapulohumeral rhythm
When considering abduction of arm from anatomical position- initially all movement at glenohumeral joint BUT beyond first 30 degrees, for every 3 degrees of abduction, 2 degrees is occurring at the shoulder joint and 1 degree is occurring at scapulothoracic joint (2:1 ratio)
Muscles ELEVATING scapula
LEVATOR SCAPULAE & UPPER TRAPEZIUS FIBRES
Muscles DEPRESSING scapula
PECTORALIS MINOR, LOWER TRAPEZIUS FIBRES, LATISSMUS DORSI & SUBCLAVUS
Muscles PROTRACTING scapula
SERRATUS ANTERIOR
Muscles RETRACTING scapula
MIDDLE TRAPEZIUS FIBRES & RHOMBOIDS
Muscles UPWARDLY ROTATING scapula
UPPER & MIDDLE TRAPEZIUS FIBRES
Muscles DOWNWARDLY ROTATING scapula
INFERIOR TRAPEZIUS, INFERIOR SERRATUS ANTERIOR & RHOMBOIDS
What type of joint is the shoulder?
Synovial ball and socket joint
What makes up the ball of the shoulder joint?
Head of humerus
What makes up the socket of the shoulder joint?
Glenoid cavity
What surrounds the socket of the shoulder joint? What’s it role?
Glenoid labrum (fibrocartilaginous cartilage) which deepens articular cavity and protects edges of the bones
Name the ligaments of the shoulder joint
CORACOHUMERAL LIGAMENT, CORACOACROMIAL ARCH & GLENOHUMERAL LIGAMENT
What is the role of the Coracohumeral Ligament?
Strengthens superior aspect of joint
What is the role of the Coracoacromial Arch?
Prevents upward displacement of the humeral head
What is the role of the Glenohumeral Ligament?
Strengthens anterior aspect of joint
What is the role of BURSAE around the shoulder joint?
Provide cushioning around joints, via fluid filled centre
What is a Bursae?
Small fluid-filled sac lined by synovial membrane with an inner capillary layer of viscous fluid
Name the bursa around the shoulder joint?
Subacromial bursa & Subscapular bursa
What is the role of the Rotator Cuff muscles?
Allow shoulder movement and gives support, preventing dislocation
What are the Rotator Cuff muscles?
SUBSCAPULARIS, SUPRASPINATUS, INFRASPINATUS & TERES MINOR
What movements do the Rotator Cuff muscles carry out on Glenohumeral joint?
FLEXION, EXTENSION, ADDUCTION, ABDUCTION, MEDIAL/LATERAL ROTATION & CIRCUMDUCTION
What are the other muscles of the Shoulder joint?
DELTOID, PECTORALIS MAJOR, PECTORALIS MINOR, SERRATUS ANTERIOR, TRAPEZIUS, TERES MAJOR & LATISSIMUS DORSI
What are the action(s) of the ANTERIOR FIBRES of DELTOID?
FLEX & MEDIALLY ROTATE SHOULDER
What are the action(s) of the MIDDLE FIBRES of DELTOID?
ABDUCT SHOULDER
What are the action(s) of the POSTERIOR FIBRES of DELTOID?
EXTEND & LATERALLY ROTATE SHOULDER
Which nerve innervates the Deltoid muscle?
AXILLARY NERVE (C5 + C6)
What are the action(s) of the PECTORALS MAJOR?
ADDUCTS & MEDIALLY ROTATES HUMERUS
Which nerve(s) innervates the Pectoralis Major muscle?
LATERAL & MEDIAL PECTORAL NERVES
What are the action(s) of the SERRATUS ANTERIOR?
PROTRACTS SCAPULAE
Which nerve innervates the SERRATUS ANTERIOR?
LONG THORACIC NERVE (C5, C6 + C7)
What are the action(s) of the SUPERIOR FIBRES of TRAPEZIUS?
ELEVATES SCAPULA
What are the action(s) of the MIDDLE FIBRES of TRAPEZIUS?
RETRACTS SCAPULA
What are the action(s) of the INFERIOR FIBRES of TRAPEZIUS?
DEPRESS SCAPULA
Which nerve innervates the TRAPEZIUS?
ACCESSORY NERVE (CN XI)
What are the action(s) of TERES MAJOR?
DEPRESS SHOULDER + ADDUCTS & MEDIALLY ROTATES HUMERUS
What are are the action(s) of LATISSIMUS DORSI?
INTERNAL ROTATION OF SHOULDER + EXTENSION
What are the compartments of the arm?
ANTERIOR (flexor) + POSTERIOR (extensor)