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Anatomy > Upper Limb > Flashcards

Upper Limb Flashcards

Pectoral Girdle & Scapular Region

1
Q

Describe the shape of each end of the clavicle. Which end is enlarged and what is this joint called? Which end is flattened and what is this joint called?

A 
Convex medially (cylindric end)
Concave laterally (flat end)
Enlarged sternal end- articulates with manubrium; Sternoclavicular joint
Flattened acromial end- articulates with acromion process; acromioclavicular joint
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2
Q

The clavicle suspends the scapula at which anatomical feature?

A

Coracoid process

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3
Q

What is significant about force put on the clavicle?

A

The clavicle transmits force from the upper limb to the axial skeleton (which is why its frequently fractured)
-Falling on outstretched arm & falling onto outside shoulder

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4
Q

What is the function of the clavicle in relation to the scapula?

A

It allows the scapula to “glide” on the thoracic wall

scapulothoracic joint

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5
Q

What are the six movements the scapulothoracic joint perform?

A

Elevation/depression
Protraction/Retraction
Upward/Downward rotation

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6
Q

What is the single articulation between the pectoral girdle and axial skeleton?

A

Sternoclavicular joint

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7
Q

How would you describe the pectoral girdle? How is this different than the pelvic girdle?

A 
Incomplete ring (open posteriorly); pelvic girdle is a complete ring
Pectoral girdle is therefore less stable/more prone to dislocation but more mobile
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8
Q

What does the coracoclavicular ligament connect?

A

It connects the coracoid process of the scapula with the clavicle

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9
Q

What are the three borders of the scapula?

A

Medial, lateral, and superior

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10
Q

What does the superior transverse scapular ligament attach to the body and what does it create?

A

It is attached to the base of the coracoid process and medial end of scapular notch
It converts the suprascapular notch into a foramen

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11
Q

What are the three angles of the scapula?

A

Superior, lateral and inferior

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12
Q

What two posterior scapular regions are divided by the scapular spine?

A

Supraspinous fossa

Infraspinous fossa

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13
Q

The acromion and clavicle form what joint? Which two directions does the acromion project in?

A

Acromioclavicular joint

Projects anteriorly and laterally

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14
Q

What is the anterior scapula surface called?

A

subscapular fossa

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15
Q

What ligament joins the clavicle and coracoid process?What side of the scapula can you see this ligament?
What is the purpose/function of this ligament?

A

Coracoclavicular ligament
Anterior
Center of balance/suspending device

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16
Q

What is the function of the glenoid fossa and what directional surface is it found on?

A

It is the “socket” for much larger humeral head

Lateral surface

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17
Q

Where do the intrinsic shoulder muscles originate and insert? What do these muscles move?

A

Appendicular skeleton

Upper limb and humerus

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18
Q

What are the two muscles and group of muscles that act on the glenohumoral (shoulder) joint/intrinsic back muscles?

A

1) . Deltoid
2) . Teres Major
3) . Rotator Cuff group

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19
Q

What four muscles make up the rotator cuff group?

A 
Supraspinatus
Infraspinatous
Teres Minor
Subscapularis
**can really be 3-6 muscles
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20
Q

What are the three portions of the deltoid muscle?

A

anterior, middle, and posterior

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21
Q

What is the origin and insertion of the deltoid?

A

O: lateral third clavicle (anterior portion), acromion (middle portion), and lateral scapular spine (lateral portion)
I: deltoid tuberosity (lateral aspect of humerus)

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22
Q

What are the three movements of the deltoid muscle?

A

Abducts arm after 15 degrees (supraspinatus abducts first 15 degrees)
Anterior portion flexes
Posterior portion extends

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23
Q

What nerve innervates the deltoid and what plexus is this a part of?

A 
Axillary nerve (C5, C6)
Terminal branch of brachial plexus
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24
Q

What boundary of the axilla does the teres major form?

A

Posterior lateral boundary

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25
Q

What is the origin and insertion of the teres major?

A

O: posterior surface of inferior scapular angle (close to superior border of latissimus dorsi)
I: Intertubercular groove of humerus (posteromedial to lat)

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26
Q

What are the two movements of the teres major?

A

Adducts & medially (interiorly) rotates humerus (like screwball)

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27
Q

What nerve is the teres major innervated by and what plexus is it a part of ?

A

Lower subscapular nerve (C5, C6); collateral branch of brachial plexus

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28
Q

What shaped muscle is the teres muscle?

A

cylindrical

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29
Q

What muscles correspond to the anterior, posterior, and superior portions of the rotator cuff?

A

Anterior- subscapularis
Posterior- Infraspinatus and Teres minor
Superior- Supraspinatus
Lack inferior support

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30
Q

What is the origin and insertion of the supraspinatus muscle?

A

O: supraspinous fossa
I: Greater tubercle (superior portion)

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31
Q

What movement does the supraspinatus perform?

A

First 15 degrees of arm abduction (helps out deltoid)

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32
Q

What nerve innervates the supraspinatus muscle and what plexus is it a part of?

A 
Suprascapular nerve (C4-C6)
Collateral branch of brachial plexus
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33
Q

What anatomical feature does the supraspinatus muscle pass under?

A

coracoacromial ligament on top of scapula

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34
Q

What artery supplies the supraspinatus?

A

Suprascapular artery

35
Q

What is the origin and insertion of the infraspinatus muscle?

A

O: infraspinous fossa of scapula
I: greater tubercle of humerus (posterior portion)

36
Q

What movement does the infraspinatus perform?

A

Laterally rotates arm (curve ball movement)

37
Q

What nerve innervates the infraspinatus and what plexus is it a part of?

A

Innervated by suprascapular nerve (C5, C6)

Collateral branch of brachial plexus

38
Q

What artery supplies the infraspinatus?

A

Suprascapular artery

39
Q

What does the suprascapular artery pass over and what does it pass deep to?

A

Over superior transverse scapular ligament

Passes deep to acromion (to enter infraspinatus fossa)

40
Q

What does the suprascapular artery form with intercostal arteries?

A

Scapular anastomosis (anastomosis joins branches of other arteries together)

41
Q

What does the suprascapular nerve pass under and pass deep to?

A

It goes under superior transverse scapular ligament, deep to acromion

42
Q

Where does the suprascapular nerve originate?

A

superior trunk of brachial plexus

43
Q

What two muscles does the suprascapular nerve innervate?

A

supraspinatus and infraspinatus

44
Q

What is the origin and insertion of the teres minor?

A

O: Lateral border of scapula (mid portion)
I: greater tubercle of humerus (posterior portion)

45
Q

What movement does the teres minor provide?

A

Lateral rotation of humerus

46
Q

What nerve is the teres minor innervated by and what plexus is it a part of?

A

Innervated by axillary nerve (C5, C6); terminal branch of the brachial plexus

47
Q

What is the origin and insertion of the subscapularis?

A

O: anterior surface of scapula
I: lesser tubercle of humerus (only rotator cuff muscle that inserts on lesser tubercle)

48
Q

What does the subscapularis form a portion of?

A

Posterior wall of axilla

49
Q

What movement does the subscapularis perform?

A

medially rotates arm (screw ball movement)

50
Q

What nerve innervates the subscapularis and what plexus is it a part of?

A

Upper & lower subscapular nerves (C5-7); collateral branches of brachial plexus

51
Q

What muscles make up the superior, lateral, inferior, and medial borders of the quadrangular space?

A

Superior- inferior border of teres minor
Lateral: surgical neck of humerus
Inferior: Superior border of teres major
Medial: lateral border of long head of triceps brachii

52
Q

What nerve and artery run through the quadrangular space?

A

Axillary nerve and posterior circumflex humeral artery

53
Q

What muscles make up the superior, lateral, and inferior portions of the Triangular space?

A

Superior: inferior border of teres minor
Lateral: medial border of long head of triceps brachii
Inferior: superior border of teres major

54
Q

What artery passes through the triangular space?

A

Circumflex scapular artery (branch of subscapular)

55
Q

What does the long head of triceps separate? Where does it originate? What is it anterior and posterior to?

A

Separates quadrangular and triangular spaces
Originates at inferior glenoid tubercle/inferior lip of glenoid fossa
It is anterior to teres minor and posterior to teres major

56
Q

What muscles make up the superior, medial, and lateral borders of the triangular interval?

A

Superior- inferior border of teres major
Medial- lateral border of long head of triceps brachii
Lateral- medial border of lateral head of triceps brachii

57
Q

What nerve and artery run through the triangular interval?

A

Radial nerve & profunda brachii artery (both course in radial/spiral groove)

58
Q

What muscles and nerve make up the anterior compartment of the posterior arm?

A

Flexors of forearm & arm

Musculocutaneous nerve

59
Q

What muscles and nerve make up the posterior compartment of the posterior arm?

A

Extensors of forearm

Radial nerve

60
Q

What two compartments does the deep fascia of the posterior arm divide into?

A

Anterior & posterior

61
Q

What is the origin and insertion of the triceps brachii?

A

O: inferior lip of glenoid fossa (long head), posterior humerus, above radial groove (lateral head), posterior humerus, below radial groove (medial head)
I: olecranon process of ulna

62
Q

What are the three heads of the triceps brachii?

A

Long, lateral & medial

63
Q

What movements does the triceps brachii perform?

A

Extends forearm; long head also extends and abducts arm

64
Q

Which triceps brachii head is least active? Most active? Strongest?

A

Least active- long head
Most active- medial head
Lateral head- strongest, only used against resistance

65
Q

What nerve is the triceps brachii innervated by?

A

Radial nerve (C6-C8)

66
Q

What muscle is the major arm extender?

A

Latissimus dorsi

67
Q

What head of the triceps brachii is obscured by the long head?

A

medial head

68
Q

What is the origin and insertion of the anconeus?

A

O: lateral epicondyle of humerus
I: lateral olecranon process & proximal ulna

69
Q

What movement does the anconeus assist with?

A

Assists in extension of forearm (crosses in elbow joint)

70
Q

What nerve innervates the anconeus?

A

radial nerve (C7-T1)

71
Q

What is the anconeus covered by?

A

Thick fascia

72
Q

What are five causes of Axillary Nerve Injury?

A

1) . Surgical neck fracture
2) . Glenohumeral dislocations
3) . Improper crutching fitting/use (supposed to sit 2 inches below axillary floor)
4) . Improper IM injections (supposed to be 2 fingerbreadths below acromion)
5) . Deltoid atrophy

73
Q

What type of pain does axillary nerve injury cause?

A

Lateral shoulder numbness

74
Q

What is degenerative tendinitis a preemptive condition for?

A

Rotator cuff tear

75
Q

How does degenerative tendinitis happen?

A

Repetitive or forceful use of upper limb above horizontal plane

76
Q

How is the pain caused when someone has degenerative tendinitis?

A

Supraspinatus tendon & humeral head grate on coracoacromial arch (supraspinatus tendon is relatively avascular)

77
Q

What pain does someone have with degenerative tendinitis?

A

Shoulder stiffness

Pain on initiating abduction or reaching behind back

78
Q

What tendon usually tears in a rotator cuff tear?

A

usually supraspinatus tendon

79
Q

What two things can cause a rotator cuff tear?

A

Fall on shoulder or forceful lifting motion

80
Q

If you have a rotator cuff injury, what two things can you not do?

A

unable to resist gravity from 90 degree abduction

cant initiate abduction

81
Q

What is a good clinical sign of a rotator cuff tear?

A

Can’t put arm behind back & can’t maintain abduction

82
Q

What two movements can lead to a glenohumeral dislocation?

A

Forceful extension & lateral rotation

83
Q

Which direction does a glenohumeral dislocation usually occur? What nerve can this affect?

A

Nearly always inferior (dislocates inferiorly & then moves humerus)
Axillary nerve in quadrangular space

84
Q

How is a glenohumeral dislocation clinically described?

A

Described by location of dislocated humeral head
anterior or posterior in relation to glenoid fossa
(anterior is most common- pectoralis major usually wins and pulls humerus)
dislocated inferior & then humerus moves anterior/posterior)

Anatomy (6 decks)

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