Upper Limb

Question 1

Describe the anatomy of the clavicle?

Answer 1

S shaped bone only attachment between the upper limb and the axial skeleton.
Contains an acromial facet and a sternal facet
Inferior and laterally possess conoïde tubercle and trapezoid line
Inferior and more medial has a subclavian groove

Question 2

What are the characteristics of the sternoclavicular joint ?

Answer 2

Synovial joint with internal cartilaginous disc
Disc located between clavicular notch of manubrium and sternal facet of clavicle
Has 4 ligaments attached: anterior and posterior sternoclavicular ligaments, the interclavicular ligaments, and the costoclavicular ligaments

Question 3

Describe the anatomy of the scapula?

Answer 3

Dorsal surface is marked by the spine which terminated at the distal end with the acromion
Lateral border of scapula gives rise centrally to coracoid process

Question 4

What are the characteristics of the acromioclavicular joints?

Answer 4

Synovial joint with internal cartilaginous disc
Disc is between the acromial facet of the clavicle and anterior end of the acromion process.
Covered by acromioclavicular ligaments which are the coracoclavicular ligaments and coracoacromial ligaments

Question 5

What are the characteristics of the coracoclavicular ligaments?

Answer 5

Consist of 2 ligaments:
Conoid ligament which attach the medial base of the coracoid process to the conoid tubercle
Trapezoid ligament which attach the lateral base of the coracoid process to the trapezoid line

Question 6

What are the characteristics of the coracoacromial ligament ?

Answer 6

Does not contact the clavicle
Attaches from acromion to the coracoid process
Form an reinforcing arch over superior surface of the glenohumeral joint

Question 7

Which are the muscles of the rotator cuff?

Answer 7

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 8

What are the characteristics of the supraspinatus?

Answer 8

Origin: Supraspinous fossa of the scapula
Insertion: Superior facet of the greater tubercle
Innervation: Suprascapular nerve
Actions: Abduction of the humerus up to 15 degrees

Question 9

What are the characteristics of the Infraspinatus?

Answer 9

Origin: Infraspinous fossa of scapula
Insertion: Middle facet of greater tubercle
Innervation: suprascapular nerve
Actions: lateral rotation of humerus

Question 10

What are the characteristics of the teres minor?

Answer 10

Origin: Middle part of lateral border of scapula
Insertion: Inferior facet of the greater tubercle
Innervation: Axillary nerve
Actions: lateral rotation of humerus

Question 11

What are the characteristics of the subscapularis?

Answer 11

Origin:Subscapularis fossa
Insertion:lesser tubercle of humerus
Innervation: Upper and lower subscapular nerves
Actions: medial rotation and adduction of the humerus

Question 12

What are the different tests for muscles weakness?

Answer 12

Drop arm test for supraspinatus- arm fully extended follow by lowering of arm, with weakness arm will drop around 15 degrees
For infraspinatus and teres minor-abduct shoulder with elbows at 90 degrees, pt pushed arms outwards against resistance

Question 13

What are the muscles attached to the scapula?

Answer 13

Posteriorly: trapezius, levator scapulae, Rhomboids
Anteriorly: serratus anterior and pectoralis minor

Question 14

What are the muscles of the pectoral region?

Answer 14

Pectoralis major
Pectoralis minor
Serratus anterior
Subclavius

Question 15

What are the characteristics of the pectoralis major?

Answer 15

Origin: clavicle, sternum and upper costal cartilages
Insertion: lateral lip of humerus
Innervation: medial and lateral pectoral nerves
Actions: medial rotation, adduction, flexes arm (pat on the back)

Question 16

What are the characteristics of the pectoralis minor?

Answer 16

Origin: Ribs 3-5
Insertion: coracoid process of scapula
Innervation: medial pectoral nerve
Actions: depression, protraction and downward rotation of scapula

Question 17

What are the characteristics of the serratus anterior?

Answer 17

Origin: ribs 1-8
Insertion: medial border of scapula
Innervation: Long thoracic nerve (C5-C7)
Actions: main protractor of scapula
Injury to long thoracic nerve causes winged scapula

Question 18

What are the characteristics of the subclavius?

Answer 18

Origin:Superior surface of distal tip and costal cartilage of 1st rib
Innervation: nerve to subclavius
Actions: depress clavicle

Question 19

What are the scapulothoracic joint ?

Answer 19

Joint formed between 3 plans of muscle
Movements smoothed by:
Subscapular bursa between subscapularis and serratus anterior
Scapulothoracic bursa between serratus anterior and external intercostals

Question 20

What are the humeral shaft muscles?

Answer 20

Deltoid

Teres major

Question 21

What are the characteristics of the deltoid?

Answer 21

Origin: lateral 1/3 clavicle, acromion process, spine of scapula
Insertion: deltoid tuberosity of the humerus
Innervation: Axillary nerve
Actions: Flexion, abduction beyond 15 degrees, extension of arm

Question 22

What are the characteristics of the Teres major?

Answer 22

Origin: Inferior angle of scapula
Insertion: medial lip of intertubular groove of humerus
Innervation: Lower subscapular nerves
Actions: Extension, adduction and medial rotation of humerus

Question 23

What are the boundaries of the axilla?

Answer 23

Medially-Lateral surface of first 5 ribs and serratus posterior
Ventrally-pectoralis major and minor
Laterally-Intertubercular groove of humerus and its medial and lateral borders
Dorsally-subscapularis and ventral surface of scapula, teres major and minor, Latissimus Dorsi
Basally-Axillary fascia and skin

Question 24

What are the fascia of the axillary region?

Answer 24

Clavipectoral fascia
Pectoral
Axillary
Deltopectoral triangle

Question 25

What are the characteristics of the brachial fascia?

Answer 25

Proximally is a continuation of the pectoral, deltoid and axillary fasciae Distally continued by the antebrachial fascia Laterally forms the lateral intermuscular septum Medially forms medial intermuscular septum Intermuscular septa divide arm into anterior (flexor) and posterior(extensor) compartments

Question 26

What are the muscles of the arm?

Answer 26

``` Bicep brachii Brachialis Coracobrachialis Brachioradialis Tricep brachii Aconeus ```

Question 27

What are the characteristics of the biceps brachii?

Answer 27

Origin: long head from supraglenoid tubercle of scapula, short head from coracoid process Insertion: Tuberosity of the radius, bicipitoradial bursa protects tendon Innervation: musculocutaneous nerve Actions: Supination, flexion of arm and forearm

Question 28

What are the characteristics of the brachialis ?

Answer 28

``` Origin: distal half of anterior surface of humerus Insertion: Ulnar tuberosity Innervation: musculocutaneous nerve Vascularization: Radial recurrent artery Actions: primary flexor of forearm ```

Question 29

What are the characteristics of the coracobrachialis?

Answer 29

Origin: coracoid process Insertion: medial surface of humerus Innervation: Musculocutaneous nerve Actions: Adduction and flexion of arm

Question 30

What are the characteristics of the brachioradialis?

Answer 30

Origin: lateral supracondylar ridge of humerus Insertion: Lateral surface of distal radius Vascularization: radial recurrent artery Actions: Flexion of elbow

Question 31

What are the characteristics of the triceps brachii?

Answer 31

Origin: long head- infraglenoid tubercle, lateral head-posterior humerus superior to radial groove, Medial head-posterior humerus inferior to radial groove Insertion:olecranon of ulna Innervation: Radial nerve Actions: Extension of elbow

Question 32

what are the characteristics of the aconeus?

Answer 32

Origin- lateral epicondyle Insertion-lateral side of olecranon Innervation- radial nerve Actions-stabilize elbow during extension

Question 33

What are the characteristics of the spaces of the upper limbs?

Answer 33

Formed by teres major and minor and long head of tricep brachii Quadrangular space-axillary nerve an posterior circumflex humeral artery Triangular space-circumflex scapular artery deep to space Triangular interval-deep artery of arm and radial nerve

Question 34

What are the characteristics of radial collateral ligament?

Answer 34

Originates from lateral epicondyle of the humerus Crosses humeroradial joint Integrates in annular ligament which maintain radioulnar joint

Question 35

What are the characteristics of the ulnar collateral ligament?

Answer 35

Spans from the radial epicondyle to the coronoid process and olecranon Possesses 3 components: anterior band, posterior band and oblique band

Question 36

What is the course of the median nerve?

Answer 36

Comes from median and lateral cords of brachial plexus Runs with brachial artery Crosses brachial artery

Question 37

What is the course of the ulnar nerve ?

Answer 37

From medial cord of brachial plexus Runs along medial side of brachial artery Pierces the medial intramuscular septum into posterior compartment Passes posterior to the medial epicondyle into the forearm