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Upper Limb Flashcards

1
Q

Origin, Insertion and Function of Subscapularis

A

O: Costal margin of the anterior scapular / Entire subscapular fossa

I: Lesser tubercle of the humerus

F: Internal rotation of the shoulder

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2
Q

Origin, Insertion and Function of Supraspinatous

A

O: Supraspinous fossa

I: Greater tubercle of the humerus
-passes under acromion, overlying subacromial bursa

F: Abduction of the shoulder

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3
Q

Origin, Insertion and Function of Infraspinatous and Teres Minor

A

O: Infraspinous fossa
Infraspinatous superior to teres minor

I: Greater tubercle of the humerus

F: Internal rotation of the shoulder

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4
Q

Origin, Insertion and Function of Teres Major

A

O: Lower lateral border of the scapula

I: Posterior lip of the bicipital groove on the humerus

F: Powerful ADductor of the shoulder

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5
Q

Origin, Insertion and Function of Coracobrachialis

A

O: Choracoid process

I: Humerus middle

F: Flexion of the shoulder

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6
Q

Origin, Insertion and Function of Serratus Anterior

A

O: Ribs 1-8
-runs underside of scapula

I: Medial border of the scapula

F: Protraction if all of it contracts

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7
Q

Origin, Insertion and Function of Levator Scapulae

A

O: C1-C3

I: Upper medial corner of the scapula

F: Elevation of the shoulder

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8
Q

Origin, Insertion and Function of Rhombus

A

O: C4-T4

I: Medial border of the scapula

F: Elevation and retraction of the shoulder

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9
Q

Origin, Insertion and Function of Trapezius

A

O Upper Part: Occipit, Nuchal ligaement, T1-T3

I Upper Part: Superior edge of the spine of the scapular, acromion and lateral 1/3 of clavicle

F Upper Part: Powerful elevation

O LOWER Part: T4-T12

I LOWER Part: Inferior edge of the spine of the scapular

F LOWER Part: Powerful retraction

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10
Q

Origin, Insertion and Function of Pectoralis Minor

A

O: Ribs 2-4

I: Coracoid process

F: Depression of the shoulder

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11
Q

2 pointless muscles of the shoulder

A

Subclavius
1st rib –> Clavicle

Omohyoid
Hyoid –> Upper edge of spine of scapular

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12
Q

Origin, Insertion and Function of Pectoralis Major

A

O: Medial 1/3 clavical, anterior sternum, anterior ribs 1-6

I: Anterior edge of bicipital groove

F: Powerful ABductor of the shoulder (+internal rotation)

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13
Q

Origin, Insertion and Function of Latissimus Dorsi

A

O: T7 - sacrum, posterior iliac crest
T7 beneath trapezius

I: Floor of bicipital groove
(tendon must spiral around teres major)

F: Powerful ABductor and depression of shoulder

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14
Q

Origin, Insertion and Function of Deltoid

A

O: Spine of scapular, acromion and lateral 1/3 clavicle

I: Deltoid tuberosity on humerus

F
Anterior: Flexion
Posterior: Extension
Lateral: ABduction

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15
Q

Spinal nerves of the upper extremity

A

C5 - T1

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16
Q

Passing of the subclavian vein in relation to the anterior scalene

A

Subclavian vein runs anterior to anterior scalene

Subclavian artery runs posterior to anterior scale (along with spinal nerves)

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17
Q

Route of the cephalic vein

A

Sits in the groove between deltoid and pectorlais major
-No corrosponding artery

Joins subclavian vein

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18
Q

Route of the subclavian vein

A

Passes beneath pectoralis minor and major

Passes under subclavius and clavicle

Passes over first rib

At medial border of first rib it is joined by internal jugular vein –> brachiocephalic vein

2 x brachiocephalic vein join to make SVC at right of midline

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19
Q

Branches of the subclavian artery

A

Internal thoracic artery

Thyrocervical trunk

Vertebral artery

Transverse cervical artery

Suprascapular artery

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20
Q

Course of subclavian artery

A

Subclavian artery branches off the brachiocephalic trunk

Passes over first rib and over dome of the pleura

Gives off:
Internal thoracic artery
Thyrocervical trunk
Vertebral artery
Transverse cervical artery
Suprascapular artery

Passes posterior to anterior scalene

Becomes axillary artery

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21
Q

Course of the axillary artery

A

Passes behind pectoralis minor

Gives off three branches in close proximity

1) Subscapular artery
2) Anterior circumflex humeral artery
3) Posterior circumflex humeral artery

Now becomes brachial artery

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22
Q

Roots of the brachial plexus

A

Ventral rami of C5 - T1

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23
Q

Trunks of the brachial plexus

A

Superior trunk formed by C5 and C6 spinal roots

Middle trunk formed by C7 spinal root

Inferior trunk formed by C8 and T1 spinal roots

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24
Q

Cords of the brachial plexus

A

Each trunk divides into anterior and posterior divions yielding 6 divisions

Lateral cord is formed by union of the two anterior divions from the superior and middle trunks

Medical cord is formed by the single anterior division from the inferior trunk

Posterior cord is formed by union of the 3 posterior divisions from the superior, middle and inferior trunk

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25
Terminal nerves of the brachial plexus
Lateral cord split to form musculocutaneous nerve and upper 1/2 of median nerve Medial cord splits to form lower 1/2 of medican nerve and entire ulnar nerve Posterior cord splits to form the axillary nerve and radial nerve
26
Local nerves of the Cords of the Brachial Plexus
Medial Cord = 1 local nerve --> Medial pectoral nerve Lateral Cord = 2 local nerves - -> Lateral pectoral nerve - ->Musculocutaneous nerve (technically a terminal nerve) Posterior Cord = 4 local nerves --> Axillary nerve, runs around neck of humerus and supplies deltoid and teres minor --> Upper and lower subscapular nerves, supplies subscapular and teres major --> Thoracodorsal nerve, supplies latissimus dorsi
27
Medial Cord local nerves
Medial pectoral nerve C8, T1 | -Part of a pair with the lateral pectoral nerve supplying pectoralis major and minor
28
Lateral Cord local nerves
Lateral pectoral nerve C5, C6 and C7 -Part of a pair with the medial pectoral nerve supplying pectoralis major and minor -Musculocutaneous nerve supplies coracobrachialis
29
Posterior Cord local nerves
4 Local Nerves Axillary nerve C5, C6 - -> Runs around the neck of the humerus with the posterior circumflex humeral artery - -> Supplies deltoid and teres minor Upper and Lower Subscapular nerves C5, C6 --> Supplies subscapular and teres major Thoracodorsal nerve C7, C8 --> Supplies Latissimus dorsi also known a sthe middle subscapular nerve
30
Origins and innervation of the Suprascapular nerve
Arises from the superior trunk of the brachial plexus as a local branch C5 and C6 Supplies supraspinatous and infraspinatous muscle
31
Origins and innervation of the Dorsal scapular nerve
Arises as a local branch from the C5 root itself, not involved in the brachial plexus - -> Passes through the middle scalene muscle - -> Supplies the rhomboid muscles
32
Origins and innervation of the Long thoracic nerve
Arises as a local branch from the C5, C6 and C7 spinal roots Not involved in the brachial plexus Emerges through the middle scalene muscle Runs posterior to the brachial plexus Supplies the serratus anterior, damage causes winging of the scapular
33
Insertion of the biceps tendon
Radial tuberosity
34
Insertion of the triceps tendon
Olecranon
35
Insertion of the brachialis tendon
Ulnar tuberosity
36
Ligaments holding ulnar and radius together
Proximal radioulnar Distal radioulnar Intraossesous membrane
37
Articulations of the elbow
Tochlear --> Torchlear notch Olecranon --> Olecranon fossa Radial head --> Capitulum Radial head --> Radial notch at ulnar
38
Ligaments of the elbow joint
Radial collateral ligament - Arises lateral epicondyle of the humerus - Fans out and becomes continuous with the annular ligament - Supinator arises from the radial collateral Ulna collateral ligament - Arises from the medical epicondyle of the humerus - Fans out in a triangle - Inserts along the medial border of the trochlear notch Annular Ligament - Encloses the end of the radial head - Arises from the radial notch - Continuous with the radial collateral ligament - Wider proximally to reflect shape of radial head
39
Radial collateral ligament
- Arises lateral epicondyle of the humerus - Fans out and becomes continuous with the annular ligament - Supinator arises from the radial collateral
40
Ulna collateral ligament
- Arises from the medical epicondyle of the humerus - Fans out in a triangle - Inserts along the medial border of the trochlear notch
41
Annular Ligament
- Encloses the end of the radial head - Arises from the radial notch - Continuous with the radial collateral ligament
42
Proximal carpal bones
Scaphoid Lunate Triquetral Pisiform
43
Distal carpal bones
Trapezium Trapezoid Capitate Hamate
44
Origins and insertion of the Radial Collateral Ligament
O: Radial Styloid I: Scaphoid and Trapezium
45
Origins and insertion of the Ulnar Collateral Ligament
O: Ulnar Styloid I: Triquetral and Pisiform
46
Flexors of the elbow joint
3 Flexors of the elbow 1) Brachialis 2) Biceps brachii 3) Brachoradialis
47
Origin, Insertion and Function of Brachialis
O: Broad area of anterior aspect of distal humerus (deep to biceps brachii) I: Ulnar tuberosity F: Flexes elbow equally well in pronation and supination
48
Origin, Insertion and Function of Biceps Brachii
O: Two Heads Long head: Supraglenoid tubercle, passes up bicipital groove into the glenoid capsule Short Head: Passes and converges with coracobrachialis and originates from the coracoid process (Anterior to brachialis) I: Main tendon inserts on the radial tuberosity Lateral fanning tendon converges and becomes cotinuous with deep fascia (bicipital aponeurosis) of the forearm and hence has indirect attachment to ulna F: Flexes elbow more efficiently in pronation as main tendon is stretched Supinates the forearm
49
Origin, Insertion and Function of Brachioradialis
O: Lateral half of distal humerus just below deltoid tuberosity I: Distal radius, long path through forearm F: Flexes elbow equally well in pronation and supination
50
Origin, Insertion and Function of Triceps
O: Three heads Long head: Arises from infraglenoid tubercle Lateral head: Proximal lateral posterior humerus Medial/Deep head: Broad origin on distal posterior medial humerus I: Converge to one large tendon on olecranon F: Extension of the elbow
51
Origin, Insertion and Function of Anconeus
O: Lateral epicondyle of the humerus I: Lateral aspect of the proximal ulna F: Flexes elbow weakly
52
Flexors of the elbow
Triceps | Anconeus
53
Pronators of the forearm
Pronator teres (powerful) Pronator quadratus
54
Supinators of the forearm
Supinator Biceps brachii -Main tendon
55
Origin, Insertion and Function of Pronator Teres
O: Two heads Medial epicondyle of the humerus Deep head arises from proximal ulna Median nerve passes between two heads of pronator teres I: 1/2 way down lateral surface of the radius F: Pronates forearm
56
Origin, Insertion and Function of Pronator Quadratus
O: Distal anteriomedial aspect of ulna I: Anterior surface of the radius F: Pronates forearm (not as powerful as pronator teres)
57
Origin, Insertion and Function of Supinator
O: Two heads - Medical epicondyle of the humerus, contuous with annular ligament - Proximal ulna at supinator crest Deep branch of radial nerve runs between the heads I: Anterior surface of the radius just proximal to pronator teres F: Supinates forearm
58
Supination caused by Biceps Brachii
Main tendon of biceps brachii inserts on the radial tuberosity When flexion component resisted by extending force of triceps tendon --> able to able powerful supination Most powerful when in flexion
59
Flexors of the wrist
3 Flexors 1) Flexor carpi radialis 2) Flexor carpi ulnaris 3) Palmaris longus
60
Extensors of the wrist
3 Extensors 1) Extensor carpi radialis longus 2) Extensor carpia radialis brevus 3) Extensor carpi ulnaris
61
Veins of the arm
Cephalic vein branches into antecubital vein at the elbow joint Cephalic bvein continues on a superficial path into the deltopectoral groove before merging with the subclavian bein Antecubital vein joins the bascilic vein at the elbow which runs up the medial side of the arm and joins the brachial vein Brachial vein adjacent to the second bachial vein before merging to form a single brachial vein As this passes into the axilla into becomes the axillary vein
62
Arteries of the Arm
Axillary artery emerges from behind pectroalis minor Passes into the arm and becomes brachial artery Gives off deep brachial (profunda brachii) adjacent to the latissimus dorsia attachment at the bicipital groove --> Deep brachial (profunda brachii) runs posteriorly deep to triceps muscle along with the radial nerve Brachial artery runs down the medial side of the arm alongside brachialis muscles, the median nerve passes anteriorly to it - -> Runs deep to bicipital aponeurosis - -> At the main biceps tendon it divides into Radial artery and Ulnar artery Radial artery maintains a superficial course between pronator teres and brachioradialis Ulnar artery dives deep to pronator teres
63
Which muscles does the musculocutaneous nerve innervate?
Coracobrachialis Biceps brachii Brachialis
64
Course of the musculocutaenous nerve
Emerges from the lateral cord of the brachial plexus C5 -C7 Runs on the underside of the coracobrachialis --> innervating it Emerges deep to biceps brachii Runs down between niceps brachii and brachialis --> innervating both of them Emerges to become lateral cutaneous nerve of the forearm
65
Course of the Radial Nerve
Radial nerve emerges from posterior cord of the brachial plexus C5 - T1 Runs posteriorly to the axillary artery It exits the axilla inferiorly (via the triangular interval), and emerges (and supplies) bewtween the long and lateral heads of the triceps brachii. Descends down the radial groove. Accompanied by the deep branch of the brachial artery. Runs anterior to the lateral epicondyle of the humerus, through the cubital fossa. ``` Then divides into two branches: Deep branch (motor) – innervates the muscles in the posterior compartment of the forearm. ``` Superficial branch (sensory) – contributes to the cutaneous innervation of the dorsal hand and fingers.
66
Contents of the Carpal Tunnel
4 flexor digitroum profundus tendons 4 flexor superficialis tendons Flexor pollicis longus tendon Median nerve
67
Borders of the anatomical snuffbox
Base of the triangle at wrist Lateral border: Abductor pollicis longus and extensor pollicis brevis Medial border: Extensor pollicis longus Floow: Scaphoid and trapezium

Anatomy (22 decks)

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