Upper Limb 6

Question 0

Trace the arteries of the upper limb.

Answer 0

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.

Question 1

What are the four divisions of the upper limb and describe them.

Answer 1

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

Question 2

The ___________ artery is deep to the ulnar and radial arteries.

Answer 2

Posterior interosseus artery

Question 3

What are the branches of the axillary artery?

Answer 3

1. Superior thoracic
2. Thoracoacromial; lateral thoracic
3. Subscapular-scapular circumflex, thoracodorsal; anterior humeral circumflex; posterior humeral circumflex

Question 4

What structure divides the axillary artery into 3 division?

Answer 4

Pectoralis minor

Question 5

The subclavian artery passes over ___________ and becomes the axillary artery.

Answer 5

First rib

Question 6

What structure creates a division between the axillary artery and brachial artery?

Answer 6

Teres major

Question 7

What are the major superficial veins of the upper limb?

Answer 7

Cephalic (from deltopectoral groove) joins the basillic vein via the median cubical vein in the cubital fossa

Question 8

What do the cephalic and basilic veins originate from (distally)?

Answer 8

Dorsal venous network (arch) of the hand

Question 9

Where does the median cubital vein lie?

Answer 9

In the cubital fossa

Question 10

Name the muscles that arise from the vertebral column and connect the upper limb to the trunk?

Answer 10

Trapezius, levator scapulae, latissimus dorsi and rhomboids

Question 11

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.

Answer 11

Trapezius (accessory n)

Question 12

Name the mm that arise from the thoracic wall and connect the upper limb to the trunk. Which one is deepest?

Answer 12

Pectoralis major/minor, subclavius, serratus anterior (deepest)

Question 13

For what two nerves is the pectoralis minor a landmark?

Answer 13

Medial and lateral pectoral n

Question 14

Explain how the lateral and medial pectoral nerves are named and what is the discrepancy?

Answer 14

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

Question 15

Name the muscles of the scapular region. Which mm are not a rotator cuff muscle?

Answer 15

Subscapularis, supraspinatus and infraspinatus, teres major/minor, deltoid
Deltoid and teres major are not rotator cuff mm

Question 16

What is the function of the rotator cuff mm?

Answer 16

Stability and movement

Question 17

Which aspect of the shoulder joint is not reinforced by the rotator cuff mm and what is this clinically important?

Answer 17

Below the glenoid cavity (inferior aspect). It can cause the shoulder to dislocate and the humerus to fall below the cavity.

Question 18

What structures pass thru the quadrangular space?

Answer 18

Axillary nerve and posterior humeral circumflex artery

Question 19

What structures pass thru the triangular space?

Answer 19

Radial nerve and profunda brachii artery

Question 20

Which muscles form the walls of the axilla? (Post, med, ant)

Answer 20

Posterior: subscapularis, teres major, lattisimus dorsi
Anterior: pectoralis major/minor, subclavius
Medial: anterior serratus, intercostal mm

Question 21

Which bones make up the borders to the axilla?

Answer 21

Ant: clavicle
Med: first rib
Post: scapula

Question 22

What are the two compartments of the upper limb?

Answer 22

Anterior: flexor
Posterior: extensor

Question 23

What two fascial structures define the two compartments of the arm?

Answer 23

Lateral and medial intermuscular septa

Question 24

Name 3 muscles in the anterior compartment of the arm, their action and innervation.

Answer 24

Coracobrachialis: flexion and adducts arm biceps brachii: flexes and supinates forearm brachialis: flexes arm and forearm Musculocutaneous nerve innervates them all.

Question 25

Name 2 muscles in the posterior compartment of the arm, it's action and what innervates it

Answer 25

Triceps brachii: extends arm and forearm Anconeus: extends elbow Radial n

Question 26

In the flexor compartment, which arm muscles cross over the elbow joint? How does this attachment affect the action of these mm?

Answer 26

Biceps and brachialis | In addition to flexing the elbow, the biceps is a powerful supinator

Question 27

The splitting of the brachial artery occurs _______ to the cubital fossa.

Answer 27

Deep

Question 28

Name the two muscles that form the boundaries of the cubital fossa.

Answer 28

Lateral: brachioradialis Medial: pronator teres

Question 29

Which of the 3 major nerves found passing from the arm into the forearm is NOT found within the cubital fossa?

Answer 29

Ulnar n

Question 30

Which muscles are found in the superficial group within the flexor compartment? Which is not innervate by the median nerve?

Answer 30

Pronator teres, *Flexor carpi radialis, Flexor carpi ulnaris, Palmaris longus, Flexor digitorum superficialis, *Brachioradialis

Question 31

Name the mm of the deep group of the flexor compartment. What is the innervation?

Answer 31

Flexor digitorum profundus-median and ulnar n | flexor pollicis longus, pronator quadratus- anterior interosseus of median n

Question 32

Which muscle of the deep group of the flexor compartment is the most medial?

Answer 32

Flexor digitorum profundus

Question 33

Name the muscles of the superficial group of extensor compartment and what innervation do they share?

Answer 33

Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris Radial n

Question 34

Name the muscles of the deep extensors and their innervation

Answer 34

Supinator, abductor pollicis longus, extensor pollicis longus/brevis, extensor indicis Radial n

Question 35

Which vessel passes into the extensor compartment to supply the muscle?

Answer 35

Posterior interosseus artery (deep branch of ulnar)

Question 36

What other artery pierces the interosseus membrane to assist in supplying these muscles?

Answer 36

Anterior interosseus art

Question 37

The dorsal carpal arch arises from the ________ artery

Answer 37

Fusion of anterior and posterior interosseus arteries

Question 38

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.

Answer 38

Snuff box | Deep palmar arch

Question 39

What structure forms the roof of the carpal tunnel?

Answer 39

Flexor rentinaculum

Question 40

Which nerve is irritated in the carpal tunnel syndrome?

Answer 40

Median

Question 41

Which nn supply the thenar muscles? Name the muscles

Answer 41

The median nerve | Abductor pollicis brevis, flexor pollicis brevis, opponens pollicis

Question 42

Names the hypothenar muscles and the nerve that supplies them.

Answer 42

Abductor digiti minimi, flexor digiti minii, opponens digit minimi Ulnar n

Question 43

What is the functional significant of the tendons of the deep digital flexors piercing the tendons of the superficial digital flexors?

Answer 43

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.

Question 44

Which two lumbricals are innervated by the median n? What innervates the remaining?

Answer 44

1st and 2nd lumbricals | Ulnar n

Question 45

All interossei are innervated by the ______ nerve

Answer 45

Ulnar

Question 46

Which artery is responsible for forming the majority of the superficial palmar arch? The deep arch?

Answer 46

Superficial: ulnar Deep: radial

Question 47

The deep palmar arch lies deep to which tendons of the hand?

Answer 47

Long flexor tendons

Question 48

What are attachments of the deltoid? Innervation and action?

Answer 48

``` Clavicle, acromion, scapular spine to deltoid tuberosity of humerus Axillary n Anterior fibers: flex arm Intermed: powerful abductor Post: flex arm ```

Question 49

What are the attachments for the supraspinatus? Innervation and action?

Answer 49

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

Question 50

What are the attachments of the infraspinatus? Innervation and action?

Answer 50

Infraspinous fossa to greater tuberosity of humerus Suprascapular n Stabilize shoulder and laterally rotate arm

Question 51

What are the attachments for teres minor? Innervation and action?

Answer 51

Lateral border of scapula to greater tuberosity of humerus Axillary n Stabilize shoulder and laterally rotate arm

Question 52

What are the attachments for subscapularis? Innervation?

Answer 52

Subscapular fossa to LESSER tuberosity of the humerus | Subscapular n

Question 53

Name attachments, Innervation and action of pectoralis major

Answer 53

1. Clavicle 2. Sternum and costal cartilage 3. Rectus sheath Inserts onto the humerus (crest of greater tuberosity) Medial and lateral pectoral nn Addiction and internal rotation

Question 54

Name attachments, innervation and action of pectoralis minor

Answer 54

Ribs 3-5 to coracoid process Medial pectoral n Draws scapula down, rotates glenoid inferiorly and assists in respiration

Question 55

Name attachment, Innervation and action of serratus anterior

Answer 55

``` 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 ```

Question 56

Name attachment, Innervation and action of teres major

Answer 56

Inferior angle of scapula to anterior crest of lesser tuberosity of the humerus Lower subscapular n Internal rotation, adduction, extension

Question 57

The bifurcation of the brachial artery occurs ________ to the bicipital aponeurosis and __________ to the tendon of the biceps brachii.

Answer 57

Deep | Superficial