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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
What are the actions of the anterior compartment of the arm
Flexion of arm and forearm
26
What muscles are in the posterior compartment of the arm
triceps brachii
27
What nerve supplies the posterior compartment of the arm
radial nerve
28
What are the actions of the posterior compartment of the arm
extension of arm and forearm
29
What muscles are in the superficial layer of the anterior compartment of the forearm
Pronator teres Flexor carpi radialis Flexor carpi ulnaris Palmaris longus
30
What muscles are in the intermediate layer of the anterior compartment of the forearm
Flexor digitorium superficialis
31
What muscles are in the deep layer of the anterior compartment of the forearm
flexor pollicius longus flexor digitorum profundus pronator quadratus
32
What muscles does the median nerve supply
``` Pronator teres Flexor carpi radialis Palmaris longus lateral half of the flexor digitorium superficialis flexor pollicius longus flexor digitorum profundus pronator quadratus ```
33
What muscles does the ulnar nerve supply
Medial half of the flexor digitorum superficialis | Flexor carpi ulnaris
34
What muscle may some people not have in their forearm
Palmaris longus
35
What are the actions of the muscles of the anterior compartment of the forearm
Flexion of wrist and digits | Pronation, abduction and adduction of the wrist
36
What muscles are in the superficial layer of the posterior compartment of the forearm
``` brachioradialis anconeus extensor carpi radialis longus extensor carpi radialis brevis extensor digitorum extensor carpi ulnaris extensor digiti minimi ```
37
What muscles are in the deep layer of the posterior compartment of the forearm
``` Supinator Abductor pollicus longus Extensor pollicis longus extensor pollicis brevis extensor indicis ```
38
What is the innervation of the posterior compartment of the forearm
radial nerve
39
what are the actions of the muscles of the posterior compartment of the forearm
Extension of the wrist and digits | Supination, abduction and adduction of the wrist.
40
What muscles are found in the thenar eminence of the hand
Abductor pollicis brevis Flexor pollicis brevis Opponens pollicis
41
What is the innervation of the thenar eminence
recurrent branch of the median nerve
42
Which eminence on the hand is affected by carpal tunnel syndrome
Thenar eminence
43
Where is the thenar eminence
Collection of muscle at the base of the thumb
44
What muscles are in the hypothenar eminence
Abductor digiti minimi Flexor digiti minimi brevis Opponens digiti minimi
45
What is the innervation of the hypothenar eminence
Deep branch of the ulnar nerve
46
What are the lumbricals
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
47
What is the innervation of the lumbricals
Median nerve for the lateral 2 | Ulnar nerve for the medial 2
48
What are the interossi
Muscles found in between metacarpals of hand Get dorsal for abduction of digits (splay fingers) Palmar for adduction - squeeze digits together
49
What is the innervation of the interossi
Ulnar nerve
50
What spinal cord levels form the brachial plexus
The anterior rami of C5-T1
51
What is the brachial plexus
A collection of nerves that supplies the whole upper limb
52
Describe the path of the brachial plexus
Rami come together and pass trough the axilla to the medial arm Cords then travel around the brachial artery
53
Name the terminal branches of the brachial plexus
``` Musculocutaneous Axillary Radial Median Ulnar ```
54
What 10 things pass through the carpal tunnel
9 tendons: - 4x flexor digitorum superficialis - 4x flexor digitorum profundus - 1x flexor pollicis longus The median nerve
55
What is carpal tunnel syndrome
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
56
List the major arteries of the upper limb
``` Subclavian artery Axillary Brachial Radial Ulnar Superficial palmar arch Deep palmar arch ```
57
Which artery is dominant in supply of the superficial palmar arch
ulnar
58
Which artery is dominant in supply of the deep palmar arch
radial
59
Why are there many anastomoses at the elbow
The brachial artery gets pinched when you bend the elbow | Anastomoses compensate for this
60
Which arteries anastomose at he scapula
Suprascapular a. Dorsal scapular a. Circumflex scapular a
61
Which structures make up the shoulder girdle
``` Clavicle Scapula Sternoclavicular joint Acromioclavicular joint Glenohumeral joint ```
62
What pathology is the AC joint susceptible to
dislocation
63
What is the origin and insertion of the trapezius muscle
Origin: Spinous processes of C7-T12 Insertion: spine of scapula
64
What is the function of the trapezius
Elevates and depresses scapula | Retracts scapula
65
What pathologies is the glenohumeral joint susceptible to
OA or RA Dislocation Adhesive capsulitis - frozen shoulder
66
What increases risk of shoulder dislocation
Trauma Lax ligaments - event triggered by mild trauma Hypermobility syndromes
67
What is the function of the labrum
Increased capture of the humeral head | This improves stability of the shoulder joint
68
What is the origin and insertion of the supraspinatus
Origin - supraspinous fossa | Insertion - greater tuberosity of the humerus
69
What is the innervation of the supraspinatus
Suprascapular nerve | C5/6
70
What is the origin and insertion of the infraspinatus
Origin: infraspinous fossa | Insertion - greater tuberosity of the humerus
71
What is the innervation of the infraspinatus
Suprascapular nerve | C5/6
72
What is the origin and insertion of the teres minor
Origin: dorsal surface of lateral border of scapula | Insertion - greater tuberosity of the humerus
73
What is the innervation of teres minor
Axillary nerve | C5/6
74
What is the origin and insertion of the subscapularis
Origin: anterior surface of scapula Insertion: lesser tuberosity of humerus
75
What is the innervation of the subscapularis
Upper and lower subscapular nerve | c5/6
76
Which pathologies are the rotator cuff muscles susceptible to
Tears - acute or degenerative | Impingement
77
What is the best investigation for rotator cuff tears
Ultrasound
78
What is the origin and insertion of the deltoid
Origin: clavicle, acromion, spine of scapula Insertion: : Deltoid tuberosity on lateral humerus
79
What is the innervation of the deltoid
Axillary nerve | C5/6
80
What is the main action of the deltoid
Abduction of the arm
81
What is the origin and insertion of the biceps brachii
Origin: short head: Coracoid process long head: Labrum / glenoid Insertion: tuberosity of the radius
82
What is the innervation of the biceps brachii
Musculocutaneous nerve | C5/6
83
What is the main action of the biceps brachii
flexes elbow | supinates forearm
84
Which pathology is the biceps brachii susceptible to
Tendonitis
85
Which areas of the elbow are prone to fracture
Olecranon Radial head/neck Supracondylar region in children
86
Which pathology is the olecranon bursae susceptible to
Bursitis Get a very swollen elbow Can get infected
87
List the ligaments that surround the elbow joint
Medial collateral Lateral collateral Annular ligament
88
What is the main function of the lateral epicondyle
The site of insertion for all of the extensor muscles of the forearm
89
Which pathology are the epicondyles susceptible to
Enthesiopathies | Lateral epicondylitis = tennis elbow
90
What is the main function of the medial epicondyle
The site of insertion for all of the flexor muscles of the forearm
91
List the carpal bones of the hand
``` Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate ```
92
Which pathologies are the bones of the hand susceptible to
OA RA Fractures Dislocation
93
What are the features of a distal radial fracture
Extra-articular | Dorsally misplaced
94
Which fracture of the hand is susceptible to AVN
Scaphoid Due to retrograde blood supply The more distal the fracture the more likely it is to heal
95
What 2 groups are the muscles of the hand divided into
Intrinsic | Extrinsic
96
Describe the intrinsic muscles of the hand
Located within the hand itself | Responsible for fine motor function
97
Describe the extrinsic muscles of the hand
Located in anterior and posterior compartments of the forearm Control finger flexion, extension and wrist movement
98
List the thenar muscles
Opponens pollicis Flexor pollicis brevis Abductor pollicis brevis
99
What is the innervation of the thenar muscles
median nerve
100
List the hypothenar muscles
Abductor digiti minimi | Flexor digiti minimi brevis
101
What is the innervation of the hypothenar muscles
ulnar nerve
102
What is the innervation of the interossi muscles
Ulnar nerve
103
What are the main actions of the interossi muscles
move the fingers (dorsal abduct and palmar adducts) | All flex the MCP joints and extend IP joints
104
Describe the lumbrical muscles
One for each fingers Link extensor and flexor tendons Crucial to finger movement
105
What is the innervation of the lumbrical muscles
Lateral x 2: Median nerve | Medial x 2: Ulnar nerve
106
Describe the flexor tendons of the hands
Extrinsic flexor muscles Pass through the carpal tunnel Kept tight to the metacarpals and phalanges by a pulley system
107
What is the main action of the flexor digitorum superficialis
Flexes fingers at the proximal interphalangeal joints
108
What is the innervation of the flexor digitorum superficialis
Median nerve | C7, C8, T1
109
What is the main action of the flexor digitorum profundus
Flexes fingers at the distal interphalangeal joints
110
What is the innervation of the flexor digitorum profundus
Median nerve-digits 2 &3 Ulnar - digits 4 &5
111
Which pulley is most commonly involved in trigger finger
A1 annular ligament | Overlies the MP joint
112
What is the main function of the palmar fascia
Separates the palmar muscle bellies and flexor tendons from the skin
113
What pathologies is the palmar fascia susceptible to
Hypertrophy | Fibrosis - dupuytren's
114
What is the major blood supply to the hand
Ulnar and radial arteries | Form deep and superficial palmar arches
115
Which 3 peripheral nerves supply cutaneous sensation to the hand
Median Ulnar Radial
116
What does the median nerve supply
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
What does the ulnar nerve supply
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
What does the radial nerve supply
Extensors of the forearm Sensation to variable portion of dorsum of hand Anatomical snuffbox
119
What forms the cubital tunnel
The two heads of the flexor carpi and the arcuate ligament | Forms an arch
120
What passes through the cubital tunnel
Ulnar nerve
121
What forms the carpal tunnel
Carpal bones | Flexor retinaculum/transverse carpal ligament
122
What are the proximal and distal attachments of latissimus dorsi
Prox - spinous process of lower 6 thoracic vertebrae, iliac crest, inferior 3/4 ribs Distal - humerus
123
What is the innervation of latissimus dorsi
Thoracodorsal nerve - C6,7,8
124
What is the main action of latissimus dorsi
Extends adducts and medially rotates humerus | Raises body towards arms when climbing
125
What are the proximal and distal attachments of levator scapulae
Prox - transverse processes of C1-4 | Distal - medial border of scapula
126
What is the innervation of levator scapulae
dorsal scapular nerve | cervical nerve
127
What is the main action of levator scapulae
Elevates scapula | Tilts glenoid cavity inferiorly by rotating scapula
128
What are the proximal and distal attachments of rhomboid major
Prox - spinous processes of T2-T5 | Distal - medial border of scapula
129
What are the proximal and distal attachments of rhomboid minor
Prox - spinous processes of C7 and T1, nuchal ligament | Distal - medial end of scapular spine
130
What is the main action of rhomboid major and minor
Retracts scapula and rotates to depress glenoid cavity
131
What is the main action of teres major
Adducts and medially rotates arm
132
What is the innervation og teres major
Lower subscapular nerve - C5,6
133
What are the proximal and distal attachments of teres major
Prox - posterior surface of inferior angle of scapula | Distal - intertubercular sulcus of humerus
134
What provides sensory innervation to the medial aspect of the posterior arm
Anterior rami of spinal nerves C8, T1 and T2
135
What provides sensory innervation to the lateral aspect of the posterior arm
Anterior rami of spinal nerves C5 & C6 via the axillary nerve.
136
What are the proximal and distal attachments of triceps brachii
Prox: Long head - infraglenoid tubercle of scapula Lateral and medial head - radial groove of humerus Distal - olecranon process of ulna
137
What does the axillary nerve supply
Deltoid and teres minor | Skin on outer arm - regimental badge area
138
What injury comes with a risk of damaging the radial nerve
(spiral) mid-shaft fracture of the humerus | Due to position in the radial groove
139
What are the proximal and distal attachments of biceps brachii
Prox: long head - supraglenoid tubercle of scapula short head - coracoid process of scapula Distal - radial tuberosity and deep fascia of medial forearm
140
What are the proximal and distal attachments of coracobrachialis
Prox - coracoid process of scapula | Distal - humerus
141
What are the proximal and distal attachments of brachialis
Prox - Humerus | Distal - coronoid process of ulna
142
What is the common site of proximal attachment of the superficial layer of anterior forearm muscles
Common flexor tendon attaches them to the medial epicondyle of the humerus
143
What is the common site of proximal attachment of the intermediate layer of anterior forearm muscles
Medial epicondyle of humerus Coronoid process of ulna Radial head
144
What is the common site of proximal attachment of the deep layer of anterior forearm muscles
Anterior surface of radius or ulna
145
What are the contents of the cubital fossa
Superficial - median cubital vein, cephalic vein and basilic vein Deep - median nerve, brachial artery, radial nerve
146
Why is sensation to central palm maintained in carpal tunnel syndrome
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
What forms the superficial palmar arch of arteries
superficial palmar branch of the ulnar artery anastomosing with the superficial palmar branch of the radial artery.
148
What forms the deep palmar arch of arteries
Deep branch of the radial artery anastomosing with the deep branch of the ulnar artery
149
What does tenderness in the anatomical snuffbox suggest
Scaphoid fracture

MSK Anatomy (4 decks)

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