Upper Limb 6 Flashcards
Trace the arteries of the upper limb.
Brachiocephalic trunk of heart - Subclavian a over first rib, under clavicle - axillary a (most superficial) - brachial artery after over teres major (profunda brachii goes unda) - branches to 1. Ulna on pinky side–>superficial palmar arch, 2. radial on thumb side–>deep palmar arch.
What are the four divisions of the upper limb and describe them.
Shoulder: pectoral, scapular, deltoid
arm: segment between the glenohumeral joint and elbow joint
forearm: between elbow and proximal wrist joints
hand: wrist to distal phalanx
The ___________ artery is deep to the ulnar and radial arteries.
Posterior interosseus artery
What are the branches of the axillary artery?
- Superior thoracic
- Thoracoacromial; lateral thoracic
- Subscapular-scapular circumflex, thoracodorsal; anterior humeral circumflex; posterior humeral circumflex
What structure divides the axillary artery into 3 division?
Pectoralis minor
The subclavian artery passes over ___________ and becomes the axillary artery.
First rib
What structure creates a division between the axillary artery and brachial artery?
Teres major
What are the major superficial veins of the upper limb?
Cephalic (from deltopectoral groove) joins the basillic vein via the median cubical vein in the cubital fossa
What do the cephalic and basilic veins originate from (distally)?
Dorsal venous network (arch) of the hand
Where does the median cubital vein lie?
In the cubital fossa
Name the muscles that arise from the vertebral column and connect the upper limb to the trunk?
Trapezius, levator scapulae, latissimus dorsi and rhomboids
One of the muscles that arise from the spine and connect the upper limb to the trunk does not receive innervation from the brachial plexus. Name it.
Trapezius (accessory n)
Name the mm that arise from the thoracic wall and connect the upper limb to the trunk. Which one is deepest?
Pectoralis major/minor, subclavius, serratus anterior (deepest)
For what two nerves is the pectoralis minor a landmark?
Medial and lateral pectoral n
Explain how the lateral and medial pectoral nerves are named and what is the discrepancy?
They are named from their anatomical relationship with the axillary artery in the brachial plexus. However, the lateral n lies more medially when it pierces the pectoralis major and the medial n lies more laterally when it pierces the pec major/minor
Name the muscles of the scapular region. Which mm are not a rotator cuff muscle?
Subscapularis, supraspinatus and infraspinatus, teres major/minor, deltoid
Deltoid and teres major are not rotator cuff mm
What is the function of the rotator cuff mm?
Stability and movement
Which aspect of the shoulder joint is not reinforced by the rotator cuff mm and what is this clinically important?
Below the glenoid cavity (inferior aspect). It can cause the shoulder to dislocate and the humerus to fall below the cavity.
What structures pass thru the quadrangular space?
Axillary nerve and posterior humeral circumflex artery
What structures pass thru the triangular space?
Radial nerve and profunda brachii artery
Which muscles form the walls of the axilla? (Post, med, ant)
Posterior: subscapularis, teres major, lattisimus dorsi
Anterior: pectoralis major/minor, subclavius
Medial: anterior serratus, intercostal mm
Which bones make up the borders to the axilla?
Ant: clavicle
Med: first rib
Post: scapula
What are the two compartments of the upper limb?
Anterior: flexor
Posterior: extensor
What two fascial structures define the two compartments of the arm?
Lateral and medial intermuscular septa
Name 3 muscles in the anterior compartment of the arm, their action and innervation.
Coracobrachialis: flexion and adducts arm
biceps brachii: flexes and supinates forearm
brachialis: flexes arm and forearm
Musculocutaneous nerve innervates them all.
Name 2 muscles in the posterior compartment of the arm, it’s action and what innervates it
Triceps brachii: extends arm and forearm
Anconeus: extends elbow
Radial n
In the flexor compartment, which arm muscles cross over the elbow joint? How does this attachment affect the action of these mm?
Biceps and brachialis
In addition to flexing the elbow, the biceps is a powerful supinator
The splitting of the brachial artery occurs _______ to the cubital fossa.
Deep
Name the two muscles that form the boundaries of the cubital fossa.
Lateral: brachioradialis
Medial: pronator teres
Which of the 3 major nerves found passing from the arm into the forearm is NOT found within the cubital fossa?
Ulnar n
Which muscles are found in the superficial group within the flexor compartment? Which is not innervate by the median nerve?
Pronator teres, *Flexor carpi radialis, Flexor carpi ulnaris, Palmaris longus, Flexor digitorum superficialis, *Brachioradialis
Name the mm of the deep group of the flexor compartment. What is the innervation?
Flexor digitorum profundus-median and ulnar n
flexor pollicis longus, pronator quadratus- anterior interosseus of median n
Which muscle of the deep group of the flexor compartment is the most medial?
Flexor digitorum profundus
Name the muscles of the superficial group of extensor compartment and what innervation do they share?
Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris
Radial n
Name the muscles of the deep extensors and their innervation
Supinator, abductor pollicis longus, extensor pollicis longus/brevis, extensor indicis
Radial n
Which vessel passes into the extensor compartment to supply the muscle?
Posterior interosseus artery (deep branch of ulnar)
What other artery pierces the interosseus membrane to assist in supplying these muscles?
Anterior interosseus art
The dorsal carpal arch arises from the ________ artery
Fusion of anterior and posterior interosseus arteries
The radial artery passes thru the _________ at the base of the thumb and then passes to the palmar surface to contribute to the formation of the ___________ arch.
Snuff box
Deep palmar arch
What structure forms the roof of the carpal tunnel?
Flexor rentinaculum
Which nerve is irritated in the carpal tunnel syndrome?
Median
Which nn supply the thenar muscles? Name the muscles
The median nerve
Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
Names the hypothenar muscles and the nerve that supplies them.
Abductor digiti minimi, flexor digiti minii, opponens digit minimi
Ulnar n
What is the functional significant of the tendons of the deep digital flexors piercing the tendons of the superficial digital flexors?
The tendons of the deep flexors extend to the distal phalanges; therefore, in order to reach this destination, they must piece the superficial to extend the middle phalanges.
Which two lumbricals are innervated by the median n? What innervates the remaining?
1st and 2nd lumbricals
Ulnar n
All interossei are innervated by the ______ nerve
Ulnar
Which artery is responsible for forming the majority of the superficial palmar arch? The deep arch?
Superficial: ulnar
Deep: radial
The deep palmar arch lies deep to which tendons of the hand?
Long flexor tendons
What are attachments of the deltoid? Innervation and action?
Clavicle, acromion, scapular spine to deltoid tuberosity of humerus Axillary n Anterior fibers: flex arm Intermed: powerful abductor Post: flex arm
What are the attachments for the supraspinatus? Innervation and action?
Supraspinatus fossa to greater tuberosity of the humerus
Suprascapular n
Stabilizes and prevents head of humerus from slipping down from the glenoid cavity; abducts the arm a little
What are the attachments of the infraspinatus? Innervation and action?
Infraspinous fossa to greater tuberosity of humerus
Suprascapular n
Stabilize shoulder and laterally rotate arm
What are the attachments for teres minor? Innervation and action?
Lateral border of scapula to greater tuberosity of humerus
Axillary n
Stabilize shoulder and laterally rotate arm
What are the attachments for subscapularis? Innervation?
Subscapular fossa to LESSER tuberosity of the humerus
Subscapular n
Name attachments, Innervation and action of pectoralis major
- Clavicle
- Sternum and costal cartilage
- Rectus sheath
Inserts onto the humerus (crest of greater tuberosity)
Medial and lateral pectoral nn
Addiction and internal rotation
Name attachments, innervation and action of pectoralis minor
Ribs 3-5 to coracoid process
Medial pectoral n
Draws scapula down, rotates glenoid inferiorly and assists in respiration
Name attachment, Innervation and action of serratus anterior
Ribs 1-9 to medial border of scapula on anterior side Long Thoracic n Superior: lowers raised arm Whole: draws scapula forward inferior: rotates scapula laterally
Name attachment, Innervation and action of teres major
Inferior angle of scapula to anterior crest of lesser tuberosity of the humerus
Lower subscapular n
Internal rotation, adduction, extension
The bifurcation of the brachial artery occurs ________ to the bicipital aponeurosis and __________ to the tendon of the biceps brachii.
Deep
Superficial
