Upper Limb Flashcards
What is the innervation of the trapezius muscle, and what is its effect on the shoulder girdle?
Innervated by CN XI
Elevates, depresses and retracts the scapula
What is the innervation and function of the levator scapulae muscle?
Innervation is by dorsal scapular nerve and direct C3-C4 fibres
Action is to elevate the scapula
What are Rhomboid Minor and Rhomboid Major innervated by?
The dorsal scapular nerve
What nerve innervates the following muscles?
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
Supraspinatus - suprascapular nerve
Infraspinatus - suprascapular nerve
Teres minor - axillary nerve
Subscapularis - upper and lower subscapular nerves
What is the action of the following muscles?
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
Supraspinatus - initiation of abduction of the arm
Infraspinatus - external rotation of the arm
Teres minor - external rotation of the arm
Subscapularis - internal rotation of the arm
Where do the heads to biceps brachii originate?
Where does this muscle insert?
Long head - supraglenoid tubercle of scapula
Short head - coracoid process of scapula
Inserts into the radial tuberosity
What three muscles are found in the anterior compartment of the arm?
What is the function of each?
What nerve supplies all of these muscles?
Biceps brachii (supination of forearm, and flexion of the arm at the shoulder and elbow)
Coracobrachialis (flexion of arm at shoulder)
Brachialis (flexion of arm at elbow)
All innervated by the musculocutaneous nerve
Where do each of the heads of the tricep originate?
Where do they all insert?
Which nerve supplies this muscle?
Long head - infraglenoid tubercule of scapula
Medial head - posterior surface of humerus
Lateral head - posterior surface of humerus
All insert on the olecranon of the ulna
Innervated by the radial nerve
What are the muscles of the superficial anterior compartment of the forearm?
What nerves supply them?
Pronator teres (median nerve)
Flexor carpi radialis (median nerve)
Palmaris longus (median nerve)
Flexor carpi ulnaris (ulnar nerve)
What is the common flexor origin for all muscles in the superficial anterior compartment of the forearm?
The medial epicondyle of the humerus
What muscle makes up the intermediate layer of the anterior compartment of the forearm?
What two structures pass between the two heads of this muscle?
What is this muscle’s action? What nerve supplies it?
Flexor digitorum superficialis
The median nerve and the ulnar artery pass between the two heads of this muscle
This muscle flexes the MCP joints (and PIP joints) of the medial 4 digits
Supplied by the median nerve
What muscles make up the deep layer of the anterior compartment of the forearm? (3)
What is their nerve supply and function?
Flexor digitorum profundus -
- medial half (ulnar nerve)
- lateral half (median nerve)
- function - flexes DIP joints of medial 4 digits
Flexor pollicis longus
- median nerve
- function - flexes IP joint of thumb
Pronator quadratus
- median nerve
- function - pronates forearm
Which nerve innervates all of the thenar muscles?
Name these muscles
The median nerve
LOAF muscles
- Lumbricals (lateral 2)
- Opponens pollicis
- Adductor pollicis brevis
- Flexor pollicis brevis
Where do all of the LOAF muscles originate? (3)
Flexor retinaculum
Scaphoid
Trapezium
Which nerve innervates all of the hypothenar muscles?
Name these muscles
The deep branch of the ulnar nerve
(from lateral to medial)
Abductor digiti minimi
Flexor digiti minimi brevis (and opponens digiti minimi)
Damage to what nerve and a resultant weakness in what muscle results in winging of the scapula?
Damage to the dorsal scapular nerve supplying serratus anterior
The long thoracic nerve comes off of which spinal nerve roots?
C5, C6 and C7
Contents of the carpal tunnel
9 tendons - 4 Flexor digitorum superficialis, 4 Flexor Digitorum profundus and 1 Flexor Pollicis longus
Median nerve
A palsy of what nerve would present with a Hand of Benediction sign when trying to make a fist?
Median nerve palsy
The interossei muscles ___ the fingers at the MCPs and ___ the fingers at the interphalangeal joints
Interossei muscles flex fingers at the MCPs and extend fingers at the IPJs
What nerve supplies all of the interossei?
Which interossei mucles abduct the fingers and which adduct?
How many are there of each?
The ulnar nerve (deep branch) innervates all of the interossei
The dorsal interossei ABDUCT the fingers at the MCP joints (DAB). There are 4 dorsal interossei
The palmar interossei ADDUCT the fingers at the MCP joints (PAD). There are 3 palmar interossei
What is the function of the lumbricals? How many are there?
Which nerve(s) innervate them?
Lumbricals link the flexor and extensor tendons for each digit, and there is one for each finger (4 total)
Innervation
- 2 lateral (lumbricals 1 and 2) - median nerve
- 2 medial (lumbricals 3 and 4) - ulnar nerve
What muscles are found in the superficial posterior compartment of the forearm? (7)
What nerve innervates all of these muscles?
- Brachioradialis
- Extensor carpi radialis longus
- Extensor carpi radialis brevis
- Anconeus
- Extensor digitorum
- Extensor carpi ulnaris
- Extensor digiti minimi
All innervated by the radial nerve
What muscles are found in the deep compartment of the forearm? (5)
What nerve innervates all of these muscles?
- Supinator
- Extensor pollicis brevis
- Abductor pollicis longus
- Extensor pollicis longus
- Extensor indices
Again, all innervated by the radial nerve
Describe the arterial supply to the arm
Subclavian artery > Brachial artery > (splits) radial and ulnar arteries
Radial and ulnar arteries from an anastomosis at the hands, creating the superficial and deep palmar arches
From these arches come the common digital arches
Describe the venous drainage of the upper limb
From the palm, the dorsal venous network drains into the cephalic and basilic veins
Laterally - cephalic vein
Medially - basilic vein
Branch runs between these two at the flexion of the elbow called the median cubital vein
The Basilic vein becomes the Brachial vein and is then joined by the cephalic vein to become the axillary vein, which then becomes the subclavian vein. The brachial vein is also joined by the venae comitantes (which accompany the brachial artery)
Artery, vein and nerve supplying the anterior compartment of the arm
Artery - brachial
Vein - brachial
Nerve - musculocutaneous
Artery, vein and nerve supplying the posterior compartment of the arm
Artery - profunda brachii
Vein - profunda brachii
Nerve - radial
Artery, vein and nerve supplying the anterior compartment of the forearm
Artery - radial and ulnar
Vein - venae comitantes
Nerve - median
Artery, vein and nerve supplying the posterior compartment of the forearm
Artery - interosseous
Vein - venae comitantes
Nerve - radial
Artery, vein and nerve supplying the hand
Artery - deep and superficial palmar branches
Vein - dorsal and palmar venous plexuses
Nerve - ulnar (and median = LOAF)
What nerves supply sensory innervation to the hand?
Median
Radial
Ulnar
The function of what nerve needs to be assessed before releasing a patient that has dislocated their shoulder?
The axillary nerve (supplies teres minor and the deltoid)
What makes up the borders of the quadrangular space?
Which nerve passes through this space?
Horizontal borders - teres major and teres minor
medial border - long head of the triceps
lateral border - humerus
Nerve - axillary nerve
