Upper Limb

Question 1

name the general arteries

Answer 1

• aorta
• aortic arch
• brachiocephalic trunk
• subclavian
• axillary
• brachial

Question 2

name the subdivisions of the subclavian artery

Answer 2

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• vertebral
• internal thoracic
• thyrocervical trunk
  
  • transverse cervical
  • suprascapular
• costocervical trunk
• dorsal scapular artery

Question 3

name the subdivions of the axillary artery

Answer 3

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• superior thoracic
• thoracoacromial
  
  • pectoral
  • acromial
  • clavicular
  • deltoid
• lateral thoracic
• posterior humeral circumflex
• anterior humeral circumflex
• subscapular
  
  • thoracodorsal
  • circumflex scapular

Question 4

name the subdivisions of the brachial artery

Answer 4

• radial
  
  • superficial palmar arch
    
    • common palmar digital
      
      • proper palmar digital
• ulnar
  
  • superficial palmar arch
    
    • common palmar digital
      
      • proper palmar digital
  • deep palmar arch
  • common interoosea
    
    • anterior interosseous
    • posterior interosseous

Question 5

name the spaces of the axilla

Answer 5

• quadrangular space
  
  • axillary nerve + posterior humeral circumflex artery
• triangular space
  
  • circumflex scapular
• triangular interval
  
  • radial nerve + deep brachial artery

Question 6

name the anastomses of the upper limb

Answer 6

• transverse cervical + suprascapular anastomose with circumflex scapular to bypass blockage in part 1 or 2 of axillary

Question 7

describe the cubital fossa

Answer 7

border

• line between the epicondyles
• pronator teres (medially)
• brachioradialis (laterally)

contents

• median nerve
• brachial artery
• biceps tendon

Question 8

describe the venous drainage of the upper arm

Answer 8

• cephalic vein (lateral)
  
  • goes up to the deltopectoral triangle
• basilic vein (medial)
  
  • joins with brachial vein to form axillary vein
• median cubital = where cephalic + basilic veins join
  
  • used for drawing blood

Question 9

name the elbow ligaments

Answer 9

• radial collateral ligament
  
  • lateral (radial = lateral)
• ulnar collateral ligament
  
  • ulnar (ulnar = medial)
• annular ligament
  
  • holds head of radius against ulnar
    
    • allows for pronation and supination

Question 10

describe “nursemaid’s elbow”

Answer 10

• radial head slips out of the annular ligament (subluxation)
• commonly occurs in young children (1-4 years)

Question 11

describe the superficial muscles of the anterior compartment

Answer 11

• superficial
  
  • pronator teres
    
    • median nerve
  • flexor carpi radialis
    
    • median nerve
    • flexes wrist
  • palmaris longus
    
    • median nerve
    • flexes wrist
  • flexor carpi ulnaris
    
    • ulnar nerve
    • flexes wrist

Question 12

describe the middle muscle of the anterior compartment

Answer 12

• flexor digitorum superficialis
  
  • median nerve
  • flexes the wrist, MCPJs (metacarpophalangeal joint), proximal IPJ (interphalangeal joint) of fingers (except thumb)
  • bye-bye flex

Question 13

describe the deep muscles of the anterior compartment

Answer 13

• flexor pollicis longus
  
  • anterior interosseous nerve
  • flexes IPJ and MCPJ of the thumb
• flexor digitorum profundus
  
  • anterior interosseous nerve (lateral half) ulnar nerve (medial half)
  • flexes wrist, MCPJs, proximal and distal IPJ of all fingers except thumb
• pronator quadtratus
  
  • anterior interosseous nerve
  • pronation

Question 14

describe the superficial layer of the posterior compartment

Answer 14

• brachioradialis
  
  • radial nerve
  • flexor in midprone position (shaking someones hand)
• extensor carpi radialis longus
  
  • radial nerve
  • extends and abducts the wrist
• extensor carpi radialis brevis
  
  • radial nerve (deep branch)
  • extends and abducts wrist
• extensor digitorum
  
  • posterior interosseous nerve
  • extends digits & wrists
• extensor carpi ulnaris
  
  • posterior interosseous nerve
  • extends and aDducts wrist
• extensor digiti minimi
  
  • posterior interosseous nerve
  • extends the pinky and wrist

Question 15

describe the deep muscles of the posterior compartment

Answer 15

• supinator
  
  • posterior interosseous
  • supination
• abductor policis longus
  
  • posterior interosseous
  • abducts CMCPJ of the thumb
• extensor policis brevis
  
  • posterior interosseous
  • extends CMCPJ and MCPJ
• extensor policis longus
  
  • posterior interosseous
  • extends IPJ, MCPJ, CMCPJ of thumb
• extensor indicis
  
  • posterior interosseous
  • extends the index finger

Question 16

name the bones

Answer 16

1. scaphoid (most commonly fractured)
2. lunate (most commonly dislocated)
3. triquetrum
4. pisiform (pea shaped)
5. trapezium
6. trapezoid
7. capitate
8. hamate

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Question 17

describe the anatomical snuff box

Answer 17

• palpate snuff box and pain = scaphoid fracture
• lateral border:
  
  • abductor pollicis longus
  • extensor pollicis brevis
• medial border:
  
  • extensor pollicis longus
• floor:
  
  • scaphoid + trapezium
• contents:
  
  • radial artery

Question 18

describe the carpal tunnel

Answer 18

• contents = 9 tendons and 1 nerve (median nerve)

Question 19

name the intrinsic muscles of the hand

Answer 19

• thenar group (median nerve):
  
  • flexor policis brevis
  • abductor policic brevis
  • opponens pollicis
• hypothenar group (deep motor branch of ulnar nerve is only motor nerve in hand)
  
  • flexor digiti minimi
  • abductor digiti minimi
  • opponens digiti minimi
• lumbricals
  
  • median 2 lumbricals = median nerve
  • lateral 2 lumbricals = ulnar nerve

Question 20

describe the dorsal and palmar interossei

Answer 20

• dorsal interossei (DAb)
  
  • abduction
  • deep branch of the ulnar nerve
• palmar interossei (PAd)
  
  • adduction
  • deep branch of the ulnar nerve
• adductor policis
  
  • adducts the thumb
  • deep motor branch of the ulnar nerve