Upper limb Flashcards
1
Q
A
Biceps brachii
2
Q
A
Brachialis
3
Q
A
Triceps brachii
4
Q
A
Anconeus
5
Q
A
Teres major
6
Q
A
Subscapularis
7
Q
A
Deltoid
8
Q
A
Coracobrachialis
9
Q
A
Supraspinatus
10
Q
A
Infraspinatus
11
Q
A
Teres minor
12
Q
A
Proximal phalanges
13
Q
A
Middle phalanges
14
Q
A
Distal phalanges
15
Q
A
Palmaris brevis
Improves the palmar grip action by pulling on the skin over the hypothenar muscles, which deepens the hollow of the palm
16
Q
A
Dorsal interossei
Abduction at the MCP joint
17
Q
A
Palmar interossei
Adduction at the MCP joint
18
Q
A
Lumbrical muscles
Flex at MCP joint and extend at IP joint
19
Q
A
Flexor retinaculum
20
Q
A
Pisiform
21
Q
A
Hook of hamate
22
Q
A
Metacarpal bones
23
Q
A
Trapezium
24
Q
A
Trapezoid
25
Capitate
26
Lunate
27
Scaphoid
28
Hamate
29
Triquetral
30
Flexor digitorum profundus
31
Pronator quadratus
32
Pronator teres
33
Flexor carpi radialis
34
Palmaris longus
Absent in 15% of the population
Does not travel through the carpal tunnel so can see the tendon at the wrist when the thumb and pinky touch
35
Flexor digitorum superficialis
(there is a flexor digitorum superficialis and profundus. Profundus means deeper. The profundus flexes the distal interphalangeal joints)
36
Flexor carpi ulnaris
37
Flexor pollicis longus
38
Brachioradialis
39
Extensor digiti minimi
40
Extensor indicis
41
Supinator
42
Extensor carpi ulnaris
43
Extensor digitorum
44
Extensor pollicis longus
45
Extensor pollicis brevis
46
Abductor pollicis longus
47
Extensor carpi radialis brevis
48
Extensor carpi radialis longus
49
What are the muscles in the superficial compartment of the anterior forearm?
Flexor carpi ulnaris
Palmaris longus
Flexor carpi radialis
Pronator teres
50
What are the muscles in the intermediate compartment of the anterior forearm?
Flexor digitorum superficialis
51
What are the muscles in the deep compartment of the anterior forearm?
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
Allow you to clench your fist then pronate it like you're ready to punch someone.
Flexor digitorum profundus + flexor pollicis longus = clenching
Pronator quadratus = pronation
52
Which nerve innervates the anterior compartment of the upper arm?
**Musculocutaneous**
## Footnote
Biceps brachii
Brachialis
Coracobrachialis
53
Which nerve innervates the posterior arm?
**Radial nerve**
## Footnote
(posterior extensors of the forearm and triceps)
54
What are the superficial muscles in the posterior compartment of the forearm?
55
What are the deep muscles in the posterior compartment of the forearm?
56
Which forearm muscles are innervated by the ulnar nerve?
Flexor carpi ulnaris
Flexor digitorum profundus (1/2 of it)
The ulnar nerve is sandwiched between these muscles
The rest of the anterior forearm is innervated by the medial nerve
57
Which hand muscles are innervated by the median nerve?
1/2 loaf
L - lateral **lumbricals** (1st and 2nd digit)
*+ the thenar muscles*
O - **opponens** **pollicis**
A - **abductor pollicis** **brevis**
F - **flexor pollicis** **brevis**
58
Which hand muscles are innervated by the median nerve?
Thenar muscles
Lateral two lumbricals
(the rest are innervated by the ulnar nerve)
59
What are the thenar muscles?
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
60
Which structures pass through the axilla?
Axillary artery
Axillary vein
Axillary lymph nodes
Brachial plexus
Biceps and coracobrachialis
61
What are the boundaries of the cubital fossa?
Superior: imaginary line between the epicondyles of the humerus
Lateral: medial border of the brachioradialis
Medial: lateral border of the pronator teres
62
What are the contents of the cubital fossa? Medial to lateral
Median nerve
Brachial artery
Biceps tendon
Radial nerve (not always considered part of the cubital fossa)
(My Bulging Biceps Rock)
63
Label this diagram
| (deep veins of the upper limb)
64
Label this diagram
| (superficial veins of the upper limb)
65
What does an upper brachial plexus injury look like and what nerve roots are affected?
C5/6
The affected limb hangs limply, medially rotated by the unopposed action of pectoralis major. The forearm is pronated due to the loss of biceps brachii. This is position is known as ‘waiter’s tip’, and is characteristic of Erb’s palsy.
66
Which nerve roots form the musculocutaneous nerve?
C5-7
67
Which nerve roots form the axillary nerve?
C5-6
68
Which nerve roots form the radial nerve?
C5-8
69
Which nerve roots form the median nerve?
C6-T1
70
Which nerve roots form the ulnar nerve?
C8-T1
71
Which artery supplies the posterior compartment of the proximal arm?
Profunda brachii/deep brachial artery
72
Which artery supplies the anterior compartment of the proximal arm?
Brachial artery
73
Which nerve innervates the anconeus?
Radial
74
Which nerve root(s) is/are involved in the biceps reflex?
C5/6
75
Which nerve root(s) is/are involved in the triceps reflex?
C7/8
76
Around which structure does the deep artery of the arm (brachial artery) run?
Radial nerve around the humeral shaft
77
Which muscles does the axillary nerve innervate?
Deltoid
Teres minor
78
How do you perform Allen's test?
1. Compress the ulnar and radial arteries at the wrist with your fingers
2. Ask the patient to make a fist to blanch the palmar skin
3. Release the ulnar artery, ask the patient to relieve their fist and view reperfusion
4. Repeat with radial artery
Tests flow through anastomotic palmar arches composed of radial and ulnar artery blood
79
What is the blood supply of the humeral head?
Circumflex arteries (branches of the axillary artery)
80
What are the two proximal attachments of the biceps brachii?
Long head: superior glenoid tubercle
Short head: coracoid process
81
What is the distal attachment of the biceps brachii?
Radial tuberosity
82
Which nerve roots can be compressed by a pancoast tumour?
C8-T1
83
What might upper extremity findings from a pancoast tumour be?
Weakness and atrophy of the intrinsic muscles of the hand
Pain and paresthesia of the fourth and fifth digits and the medial aspect of the arm and forearm
84
Which muscles form the mobile wad of the arm?
1. Brachioradialis
2. Extensor carpi radialis brevis
3. Extensor carpi radialis longus
85
What are the 3 heads of the triceps brachii?
Lateral
Medial
Long
86
Where does the radial nerve become the posterior interosseous nerve?
As it pierces the supinator
87
Which muscles does the posterior interosseous nerve innervate?
Muscles of the posterior forearm EXCEPT for the extensor carpi radialis longus and brachioradialis (both radial nerve)
88
Which forearm muscles does the median nerve run between?
Flexor digitorum profundus
Flexor digitorum superficialis
89
Which muscle does the median nerve pierce?
Pronator teres
90
Which muscle does the ulnar nerve pierce in the forearm?
Flexor carpi ulnaris
91
What are the borders of the cubital tunnel?
Distal: cubital tunnel retinaculum (ligament or band of Osborne)
Lateral: olecranon process
Medial: medial epicondyle
Proximal: two heads of the flexor carpi ulnaris
93
The deep palmar arch is predominantly supplied by which artery?
Radial
94
Which nerve provides sensation to the dorsal web space between the thumb and the index finger?
Radial nerve
95
What is the action of the lumbricals?
Flexion of the MCP, extension of the PIP and DIP joints
97
From which palmar arch do the digital arteries arise?
Superficial
98
Which muscles are supplied by the anterior interosseous nerve?
Flexor pollicis longus
Pronator quadratus
Flexor digitorum profundus (lateral half)
*Deep forearm muscles*
99
How is the function of the anterior interosseous nerve tested?
OK sign
100
How is the median nerve tested?
Thumb abduction against resistance
101
The superficial palmar arch is predominantly supplied by which artery?
Ulnar
103
What is the action of the palmar interossei?
Finger adduction
PAD - Palmars ADduct
104
What type of joint is the 1st carpometacarpal joint?
Saddle joint
105
What type of joint are the 2nd-5th carpometacarpal joints and the metacarpophalangeal joints?
Ellipsoid/condylar
106
List 2 factors that make the thumb more mobile than the other phalanges
1. Deep transverse metacarpal ligament does not connect to the thumb
2. It is a saddle joint
107
What type of joint are the interphalangeal joints?
Hinge
108
Which structures pass through the carpal tunnel?
Flexor digitorum profundus tendon x4
Flexor digitorum superficialis tendon x4
Flexor pollicis longus tendon
Median nerve (anterior to the tendons)
109
What are the borders of the anatomical snuffbox?
Lateral: abductor pollicis longus and extensor pollicis brevis tendon
Medial: extensor pollicis longus tendon
Floor: scapoid and trapezium
110
What is the action of the dorsal interossei?
Finger abduction
DAB - Dorsals ABduct
112
Which landmark can be used to help find the radial pulse?
Tendon of the flexor carpi radialis
| (radial pulse lies laterally)
116
Which bones form the carpal arch?
Pisiform, hook of hamate, scaphoid, trapezium
117
Which muscle(s) contribute to extension at the IP joints?
Extensor digitorum (weak)
118
What causes ape hand?
Medial nerve injury leading to weakness in the thenar muscles and unopposed action of the adductor pollicis
125
Which structures pass through the anatomical snuffbox?
1. Radial artery
2. Origin of the cephalic vein
3. Terminal parts of the superficial branch of the radial nerve
129
Which muscles abduct the wrist?
Flexor carpi radialis and extensor carpis radialis (longus and brevis)
130
Which muscles adduct the wrist?
Flexor carpi ulnaris and extensor carpi ulnaris
131
Which muscle(s) contribute to extension at the MCP joints?
Extensor digitorum (radial)
132
Which muscle(s) contribute to flexion at the MCP?
Lumbricals
134
Which muscle(s) contribute to flexion at the IP joints?
Flexor digitorum superficialis (PIP) and profundus (DIP)
135
Why do the digits take on a slightly flexed position at rest?
Flexion by the flexor digitorum superficialis and profundus is stronger than extension by the extensor digitorum
136
Coronoid fossa of the humerus
Receives the coronoid process of the ulna during flexion of the forearm
Adjacent to the radial fossa of the humerus
137
Medial epicondyle of the humerus
138
Lateral epicondyle of the humerus
139
Medial supracondylar ridge
140
Coracoid process
141
Body of the humerus
142
Lesser tubercle
143
Greater tubercle
144
Surgical neck of the humerus
145
Anatomical neck of the humerus
146
Head of the humerus
147
Acromion
148
Supradeltoid bursa and subacromial bursa
149
Coracoclavicular ligament
150
Coracoacromial ligament
151
Glenohumeral ligaments
152
Supraglenoid tubercle
153
Infraglenoid tubercle
154
Medial border of the scapula
155
Subscapular fossa
156
Supraspinous fossa
157
Infraspinous fossa
158
Neck of the scapula
159
Glenoid cavity
160
Trochlea of the humerus
161
Capitulum of the humerus
162
Olecranon fossa
163
Radial fossa
164
Infraspinatus
165
Teres minor
166
Teres major
167
Deltoid muscle
168
Biceps brachii muscle
169
Brachialis muscle
170
Triceps brachii muscle
171
Anconeus muscle
172
Subscapularis muscle
173
Supraspinatus muscle
174
Latissimus dorsi muscle
175
Pectoralis major muscle
176
Coracobrachialis muscle
177
Axillary artery
178
Brachial artery
179
Anterior humeral circumflex artery
180
Posterior humeral circumflex artery
181
Circumflex scapular artery
182
Deep brachial artery
183
Subclavian artery
184
Thoracoacromial artery
185
Ulnar artery
186
Axillary vein
187
Basilic vein
188
Brachial veins
189
Cephalic vein
190
Subclavian vein
191
Which muscles attach to the greater tuberosity of the humerus?
Supraspinatus
Infraspinatus
Teres minor
192
Which muscle(s) attach to the lesser tuberosity of the humerus?
Subscapularis
195
What is the innervation of the subscapularis?
Upper and lower subscapular nerves
(from the posterior chord of the brachial plexus)
196
What are the borders of the quadrangular space?
Superior: teres minor
Inferior: teres major
Medial: long head of triceps
Lateral: humeral shaft
197
What are the borders of the triangular space?
Inferior: teres major
Lateral: long head of triceps
Superior: lower border of teres minor
199
What are the borders of the triangular interval?
Superior: teres major
Lateral: lateral head of the triceps or the humerus
Medial: long head of the triceps
201
Draw the brachial plexus
202
What are the contents of the quadrangular space?
Axillary nerve
Posterior humeral circumflex artery
203
What are the contents of the triangular space?
Scapular circumflex artery
204
What are the contents of the triangular interval?
Profunda brachii artery
Radial nerve
259
What is the main function of the supraspinatus?
Arm abduction (particularly initiation of abduction)
260
What is the major function of the infraspinatus?
External rotation of the shoulder
261
What is the major function of the subscapularis?
Internal rotation of the shoulder
262
What is the innervation of the supraspinatus?
Suprascapular nerve
263
What is the innervation of the infraspinatus?
Suprascapular nerve
267
What are the contents of the triangular space?
Scapular circumflex artery
269
What are the contents of the triangular interval?
Profunda brachii artery
Radial nerve
270
What type of joint is the humeroulnar joint?
Hinge
271
What type of joint is the wrist?
Condyloid/ellipsoid
272
Damage to which nerve causes a winged scapula?
Long thoracic
## Footnote
*Serratus anterior*
