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MSK Anatomy > Upper Limb > Flashcards

Upper Limb Flashcards

1
Q

List the joints of the upper limb and what type they are- proximal to distal

A

Sternoclavicular - saddle
Acromioclavicular - plane
Glenohumeral - ball and socket
Elbow: made up of humeroulnar & radiohumeral - hinge
Proximal and distal radioulnar joints - pivot
Radiocarpal joint - ellipsoid

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2
Q

What joint provides the only point of contact between the upper limb and the axial skeleton

A

Sternoclavicular joint

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3
Q

Describe the movement of the forearm bones during pronation

A

As you turn your hand over, the radius crosses over the ulna
Ulna stays still

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4
Q

List the joints of the hand

A

Distal and proximal interphalangeal joints - in fingers
Metacarpophalangeal joints - main knuckle
Carpometacarpal joint - thumb

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5
Q

What type of joint are the MCPs

A

Condyloid type

Allows movement of finger in a circle

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6
Q

What type of joint is the CMC

A

Saddle type

Allows movement in pretty much all directions but is very stable

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7
Q

List the axio-appendicular muscles

A 
Trapezius 
Serratus anterior 
Rhomboid major and minor 
Subclavius 
Latissimus dorsi 
Levator scapulae
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8
Q

What is the innervation of the trapezius

A

CNXI

spinal accessory nerve

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9
Q

What is the innervation of serratus anterior

A

long thoracic nerve

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10
Q

What is the innervation of the rhomboid major and minor

A

dorsal scapula nerve

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11
Q

What do the axio-appendicularmuscles connect

A

The arm to the axial skeleton

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12
Q

What is the innervation of the levator scapulae

A

Dorsal scapula nerve

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13
Q

What is the function of the rotator cuff muscles

A

Keeps the humeral head in the glenohumeral joint
Positions it
Maintains stability

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14
Q

Name the 4 rotator cuff muscles

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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15
Q

Which rotator cuff muscles attach to the greater tuberosity of the humerus

A

Supraspinatus
Infraspinatus
Teres minor

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16
Q

Which rotator cuff muscles attach to the lesser tuberosity of the humerus

A

Subscapularis

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17
Q

What movement does the supraspinatus allow

A

Abduction of the arm

Only the first 15 degrees, after this the deltoid takes over

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18
Q

What movement does the subscapularis allow

A

Medial rotation of the arm

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19
Q

What movement does the infraspinatus and teres minor allow

A

Lateral rotation

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20
Q

Which of the rotator cuff muscles is most commonly disrupted

A

Supraspinatus

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21
Q

How many compartments are in the arm

A

2

anterior and posterior

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22
Q

How many compartments are in the forearm

A

2

anterior and posterior

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23
Q

What muscles are found in the anterior compartment of the arm

A

Biceps brachii
Brachialis
Coracobrachialis

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24
Q

What nerve innervates the anterior compartment of the arm

A

Musculocutaneous

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25
Q

What are the actions of the anterior compartment of the arm

A

Flexion of arm and forearm

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26
Q

What muscles are in the posterior compartment of the arm

A

triceps brachii

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27
Q

What nerve supplies the posterior compartment of the arm

A

radial nerve

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28
Q

What are the actions of the posterior compartment of the arm

A

extension of arm and forearm

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29
Q

What muscles are in the superficial layer of the anterior compartment of the forearm

A

Pronator teres
Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus

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30
Q

What muscles are in the intermediate layer of the anterior compartment of the forearm

A

Flexor digitorium superficialis

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31
Q

What muscles are in the deep layer of the anterior compartment of the forearm

A

flexor pollicius longus
flexor digitorum profundus
pronator quadratus

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32
Q

What muscles does the median nerve supply

A 
Pronator teres 
Flexor carpi radialis 
Palmaris longus 
lateral half of the flexor digitorium superficialis 
flexor pollicius longus 
flexor digitorum profundus 
pronator quadratus
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33
Q

What muscles does the ulnar nerve supply

A

Medial half of the flexor digitorum superficialis

Flexor carpi ulnaris

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34
Q

What muscle may some people not have in their forearm

A

Palmaris longus

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35
Q

What are the actions of the muscles of the anterior compartment of the forearm

A

Flexion of wrist and digits

Pronation, abduction and adduction of the wrist

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36
Q

What muscles are in the superficial layer of the posterior compartment of the forearm

A 
brachioradialis 
anconeus
extensor carpi radialis longus 
extensor carpi radialis brevis 
extensor digitorum 
extensor carpi ulnaris 
extensor digiti minimi
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37
Q

What muscles are in the deep layer of the posterior compartment of the forearm

A 
Supinator 
Abductor pollicus longus 
Extensor pollicis longus 
extensor pollicis brevis 
extensor indicis
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38
Q

What is the innervation of the posterior compartment of the forearm

A

radial nerve

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39
Q

what are the actions of the muscles of the posterior compartment of the forearm

A

Extension of the wrist and digits

Supination, abduction and adduction of the wrist.

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40
Q

What muscles are found in the thenar eminence of the hand

A

Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis

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41
Q

What is the innervation of the thenar eminence

A

recurrent branch of the median nerve

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42
Q

Which eminence on the hand is affected by carpal tunnel syndrome

A

Thenar eminence

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43
Q

Where is the thenar eminence

A

Collection of muscle at the base of the thumb

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44
Q

What muscles are in the hypothenar eminence

A

Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi

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45
Q

What is the innervation of the hypothenar eminence

A

Deep branch of the ulnar nerve

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46
Q

What are the lumbricals

A

Muscles in the hand that attach to the tendons of the flexor digitorum profundus
Connect anterior aspect of hand to the posterior aspect of the fingers
They flex fingers forward

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47
Q

What is the innervation of the lumbricals

A

Median nerve for the lateral 2

Ulnar nerve for the medial 2

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48
Q

What are the interossi

A

Muscles found in between metacarpals of hand
Get dorsal for abduction of digits (splay fingers)
Palmar for adduction - squeeze digits together

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49
Q

What is the innervation of the interossi

A

Ulnar nerve

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50
Q

What spinal cord levels form the brachial plexus

A

The anterior rami of C5-T1

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51
Q

What is the brachial plexus

A

A collection of nerves that supplies the whole upper limb

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52
Q

Describe the path of the brachial plexus

A

Rami come together and pass trough the axilla to the medial arm
Cords then travel around the brachial artery

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53
Q

Name the terminal branches of the brachial plexus

A 
Musculocutaneous 
Axillary 
Radial 
Median 
Ulnar
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54
Q

What 10 things pass through the carpal tunnel

A

9 tendons:

  • 4x flexor digitorum superficialis
  • 4x flexor digitorum profundus
  • 1x flexor pollicis longus

The median nerve

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55
Q

What is carpal tunnel syndrome

A

Occurs when there is compression of the median nerve

Leads to weakness in the thenar muscles and numbness in digits 1-3 and half of digit 4

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56
Q

List the major arteries of the upper limb

A 
Subclavian artery 
Axillary 
Brachial 
Radial 
Ulnar 
Superficial palmar arch 
Deep palmar arch
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57
Q

Which artery is dominant in supply of the superficial palmar arch

A

ulnar

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58
Q

Which artery is dominant in supply of the deep palmar arch

A

radial

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59
Q

Why are there many anastomoses at the elbow

A

The brachial artery gets pinched when you bend the elbow

Anastomoses compensate for this

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60
Q

Which arteries anastomose at he scapula

A

Suprascapular a.
Dorsal scapular a.
Circumflex scapular a

61
Q

Which structures make up the shoulder girdle

A 
Clavicle 
Scapula 
Sternoclavicular joint 
Acromioclavicular joint 
Glenohumeral joint
62
Q

What pathology is the AC joint susceptible to

A

dislocation

63
Q

What is the origin and insertion of the trapezius muscle

A

Origin: Spinous processes of C7-T12
Insertion: spine of scapula

64
Q

What is the function of the trapezius

A

Elevates and depresses scapula

Retracts scapula

65
Q

What pathologies is the glenohumeral joint susceptible to

A

OA or RA
Dislocation
Adhesive capsulitis - frozen shoulder

66
Q

What increases risk of shoulder dislocation

A

Trauma
Lax ligaments - event triggered by mild trauma
Hypermobility syndromes

67
Q

What is the function of the labrum

A

Increased capture of the humeral head

This improves stability of the shoulder joint

68
Q

What is the origin and insertion of the supraspinatus

A

Origin - supraspinous fossa

Insertion - greater tuberosity of the humerus

69
Q

What is the innervation of the supraspinatus

A

Suprascapular nerve

C5/6

70
Q

What is the origin and insertion of the infraspinatus

A

Origin: infraspinous fossa

Insertion - greater tuberosity of the humerus

71
Q

What is the innervation of the infraspinatus

A

Suprascapular nerve

C5/6

72
Q

What is the origin and insertion of the teres minor

A

Origin: dorsal surface of lateral border of scapula

Insertion - greater tuberosity of the humerus

73
Q

What is the innervation of teres minor

A

Axillary nerve

C5/6

74
Q

What is the origin and insertion of the subscapularis

A

Origin: anterior surface of scapula
Insertion: lesser tuberosity of humerus

75
Q

What is the innervation of the subscapularis

A

Upper and lower subscapular nerve

c5/6

76
Q

Which pathologies are the rotator cuff muscles susceptible to

A

Tears - acute or degenerative

Impingement

77
Q

What is the best investigation for rotator cuff tears

A

Ultrasound

78
Q

What is the origin and insertion of the deltoid

A

Origin: clavicle, acromion, spine of scapula
Insertion: : Deltoid tuberosity on lateral humerus

79
Q

What is the innervation of the deltoid

A

Axillary nerve

C5/6

80
Q

What is the main action of the deltoid

A

Abduction of the arm

81
Q

What is the origin and insertion of the biceps brachii

A

Origin: short head: Coracoid process
long head: Labrum / glenoid
Insertion: tuberosity of the radius

82
Q

What is the innervation of the biceps brachii

A

Musculocutaneous nerve

C5/6

83
Q

What is the main action of the biceps brachii

A

flexes elbow

supinates forearm

84
Q

Which pathology is the biceps brachii susceptible to

A

Tendonitis

85
Q

Which areas of the elbow are prone to fracture

A

Olecranon
Radial head/neck
Supracondylar region in children

86
Q

Which pathology is the olecranon bursae susceptible to

A

Bursitis
Get a very swollen elbow
Can get infected

87
Q

List the ligaments that surround the elbow joint

A

Medial collateral
Lateral collateral
Annular ligament

88
Q

What is the main function of the lateral epicondyle

A

The site of insertion for all of the extensor muscles of the forearm

89
Q

Which pathology are the epicondyles susceptible to

A

Enthesiopathies

Lateral epicondylitis = tennis elbow

90
Q

What is the main function of the medial epicondyle

A

The site of insertion for all of the flexor muscles of the forearm

91
Q

List the carpal bones of the hand

A 
Scaphoid 
Lunate 
Triquetrum 
Pisiform 
Trapezium 
Trapezoid 
Capitate 
Hamate
92
Q

Which pathologies are the bones of the hand susceptible to

A

OA
RA
Fractures
Dislocation

93
Q

What are the features of a distal radial fracture

A

Extra-articular

Dorsally misplaced

94
Q

Which fracture of the hand is susceptible to AVN

A

Scaphoid
Due to retrograde blood supply
The more distal the fracture the more likely it is to heal

95
Q

What 2 groups are the muscles of the hand divided into

A

Intrinsic

Extrinsic

96
Q

Describe the intrinsic muscles of the hand

A

Located within the hand itself

Responsible for fine motor function

97
Q

Describe the extrinsic muscles of the hand

A

Located in anterior and posterior compartments of the forearm
Control finger flexion, extension and wrist movement

98
Q

List the thenar muscles

A

Opponens pollicis
Flexor pollicis brevis
Abductor pollicis brevis

99
Q

What is the innervation of the thenar muscles

A

median nerve

100
Q

List the hypothenar muscles

A

Abductor digiti minimi

Flexor digiti minimi brevis

101
Q

What is the innervation of the hypothenar muscles

A

ulnar nerve

102
Q

What is the innervation of the interossi muscles

A

Ulnar nerve

103
Q

What are the main actions of the interossi muscles

A

move the fingers (dorsal abduct and palmar adducts)

All flex the MCP joints and extend IP joints

104
Q

Describe the lumbrical muscles

A

One for each fingers
Link extensor and flexor tendons
Crucial to finger movement

105
Q

What is the innervation of the lumbrical muscles

A

Lateral x 2: Median nerve

Medial x 2: Ulnar nerve

106
Q

Describe the flexor tendons of the hands

A

Extrinsic flexor muscles
Pass through the carpal tunnel
Kept tight to the metacarpals and phalanges by a pulley system

107
Q

What is the main action of the flexor digitorum superficialis

A

Flexes fingers at the proximal interphalangeal joints

108
Q

What is the innervation of the flexor digitorum superficialis

A

Median nerve

C7, C8, T1

109
Q

What is the main action of the flexor digitorum profundus

A

Flexes fingers at the distal interphalangeal joints

110
Q

What is the innervation of the flexor digitorum profundus

A

Median nerve-digits 2 &3 Ulnar - digits 4 &5

111
Q

Which pulley is most commonly involved in trigger finger

A

A1 annular ligament

Overlies the MP joint

112
Q

What is the main function of the palmar fascia

A

Separates the palmar muscle bellies and flexor tendons from the skin

113
Q

What pathologies is the palmar fascia susceptible to

A

Hypertrophy

Fibrosis - dupuytren’s

114
Q

What is the major blood supply to the hand

A

Ulnar and radial arteries

Form deep and superficial palmar arches

115
Q

Which 3 peripheral nerves supply cutaneous sensation to the hand

A

Median
Ulnar
Radial

116
Q

What does the median nerve supply

A

Flexors of the forearm 0 LOAF muscles
Sensation to radial 3.5 digits (index, middle, half of thumb and half of ring)
central/lateral palm
skin over distal phalanges of stated fingers

117
Q

What does the ulnar nerve supply

A

Intrinsic muscles of the hand
Sensation to 1.5 digits (pinky and half of ring) and medial part of palm
medial part of dorsum of hand

118
Q

What does the radial nerve supply

A

Extensors of the forearm
Sensation to variable portion of dorsum of hand
Anatomical snuffbox

119
Q

What forms the cubital tunnel

A

The two heads of the flexor carpi and the arcuate ligament

Forms an arch

120
Q

What passes through the cubital tunnel

A

Ulnar nerve

121
Q

What forms the carpal tunnel

A

Carpal bones

Flexor retinaculum/transverse carpal ligament

122
Q

What are the proximal and distal attachments of latissimus dorsi

A

Prox - spinous process of lower 6 thoracic vertebrae, iliac crest, inferior 3/4 ribs

Distal - humerus

123
Q

What is the innervation of latissimus dorsi

A

Thoracodorsal nerve - C6,7,8

124
Q

What is the main action of latissimus dorsi

A

Extends adducts and medially rotates humerus

Raises body towards arms when climbing

125
Q

What are the proximal and distal attachments of levator scapulae

A

Prox - transverse processes of C1-4

Distal - medial border of scapula

126
Q

What is the innervation of levator scapulae

A

dorsal scapular nerve

cervical nerve

127
Q

What is the main action of levator scapulae

A

Elevates scapula

Tilts glenoid cavity inferiorly by rotating scapula

128
Q

What are the proximal and distal attachments of rhomboid major

A

Prox - spinous processes of T2-T5

Distal - medial border of scapula

129
Q

What are the proximal and distal attachments of rhomboid minor

A

Prox - spinous processes of C7 and T1, nuchal ligament

Distal - medial end of scapular spine

130
Q

What is the main action of rhomboid major and minor

A

Retracts scapula and rotates to depress glenoid cavity

131
Q

What is the main action of teres major

A

Adducts and medially rotates arm

132
Q

What is the innervation og teres major

A

Lower subscapular nerve - C5,6

133
Q

What are the proximal and distal attachments of teres major

A

Prox - posterior surface of inferior angle of scapula

Distal - intertubercular sulcus of humerus

134
Q

What provides sensory innervation to the medial aspect of the posterior arm

A

Anterior rami of spinal nerves C8, T1 and T2

135
Q

What provides sensory innervation to the lateral aspect of the posterior arm

A

Anterior rami of spinal nerves C5 & C6 via the axillary nerve.

136
Q

What are the proximal and distal attachments of triceps brachii

A

Prox:
Long head - infraglenoid tubercle of scapula
Lateral and medial head - radial groove of humerus

Distal - olecranon process of ulna

137
Q

What does the axillary nerve supply

A

Deltoid and teres minor

Skin on outer arm - regimental badge area

138
Q

What injury comes with a risk of damaging the radial nerve

A

(spiral) mid-shaft fracture of the humerus

Due to position in the radial groove

139
Q

What are the proximal and distal attachments of biceps brachii

A

Prox:
long head - supraglenoid tubercle of scapula
short head - coracoid process of scapula

Distal - radial tuberosity and deep fascia of medial forearm

140
Q

What are the proximal and distal attachments of coracobrachialis

A

Prox - coracoid process of scapula

Distal - humerus

141
Q

What are the proximal and distal attachments of brachialis

A

Prox - Humerus

Distal - coronoid process of ulna

142
Q

What is the common site of proximal attachment of the superficial layer of anterior forearm muscles

A

Common flexor tendon attaches them to the medial epicondyle of the humerus

143
Q

What is the common site of proximal attachment of the intermediate layer of anterior forearm muscles

A

Medial epicondyle of humerus
Coronoid process of ulna
Radial head

144
Q

What is the common site of proximal attachment of the deep layer of anterior forearm muscles

A

Anterior surface of radius or ulna

145
Q

What are the contents of the cubital fossa

A

Superficial - median cubital vein, cephalic vein and basilic vein
Deep - median nerve, brachial artery, radial nerve

146
Q

Why is sensation to central palm maintained in carpal tunnel syndrome

A

The palmar cutaneous branch of the median nerve is given off the main median nerve before it enters the tunnel so isn’t affected by compression

147
Q

What forms the superficial palmar arch of arteries

A

superficial palmar branch of the ulnar artery anastomosing with the superficial palmar branch of the radial artery.

148
Q

What forms the deep palmar arch of arteries

A

Deep branch of the radial artery anastomosing with the deep branch of the ulnar artery

149
Q

What does tenderness in the anatomical snuffbox suggest

A

Scaphoid fracture

MSK Anatomy (4 decks)

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