upper limb Flashcards
what muscles extend the wrist
extensor carpi radialis longus/ brevis
extensor carpi ulnaris
extensor digitorum
what are the attachments of the levator scapulae
transvers processes of C1-4
attaches to medial border of scapula
what are the actions of the biceps branchii
supinate forearm
flex arm at the elbow and shoulder
what is the function of the anterior fibres of the deltoid
flex arm at the shoulder
what is the innervation of flexor digitorum profundus
medial - ulnar nerve (pinky and ring finger)
lateral - median nerve (middle and index finger)
what are the attachments of the abductor pollicis longus
interosseous membrane
lateral base of thumb
what are the attachments of the extensor pollicis brevis
posterior ulna/ interossuss membrane
to to proximal phalanx
what tendon runs through the inter tubercular groove on the humerus head
long head of biceps branchii
what is the action of pronator teres
pronate forearm
what is the innervation of the teres major
lower scapular nerve
what muscle attatches to the ulnar anteriorly and distally
pronator quadratus
what makes the proximal border of the anatomical snuff box
styloid process of the radius
can be palpated
how does the median nerve enter the hand
through the carpal tunnel
which strong ligaments aids in the movement of the clavicle
costoclavicular
what is the sensory function of the radial nerve
posterior forearm
dorsal surface of lateral 3 digits and associated palm area
what two muscles of the upper arm travel through the axilla to reach the coracoid process
biceps branchii
coracobrachialis
what is the most common type of radial fracture
collets fracture - fall onto outstretched hand causing fracture of distal radius - dinner fork deformity
what type of joint is the proximal radioulnar joint
synovial pivot - pronation, supination
what are the branches of the lateral cord
musculotcutaneous nerve
lateral pectoral nerve
lateral root of median nerve
what cord does the median nerve come from
medial and lateral - C6- T1
where does the lateral head of the triceps brachii originate
humerus, superior to radial groove
what is the action of extensor indices proprius
extend the index finger
what are the 4 muscles of the upper arm
biceps branchii
brachialis
coracobrachialis
triceps branchii
what 2 things articulate at the proximal and distal radio-ulnar joints - SPECIFIC
proximal - radial head + radial notch of ulna
distal - ulnar head + ulnar notch of radius
what cord does the ulnar nerve come from
medial (C8-T1)
what 2 muscles in the anterior forearm does the ulnar nerve supply (rest median)
flexor carpi ulnaris
medial half of flexor digitorum profundus
does the capitulum of the humerus articulate with the radius or the ulnar?
head of radius
what is the innervation of the serrates anterior
long thoracic nerve
where does the radial (lateral) collateral ligament extend between
lateral epicondyle and blends with annular ligament of radioulnar joint
what is the innervation of the brachioradialis
radial nerve
what 2 muscles form the floor of the cubital fossa
brachialis and supinator
what are the attachments of extensor indicis proprius
posterior ulna/ interosseus membrane
to index finger
what 2 things form the trochlear notch on the ulna
olecranon
coronoid process
where does the brachial artery birfurcate
apex of cubital fossa
what muscles depress the scapula
trapezius
pectorals minor
lattisimus dorsi
what shape is the deltoid muscle
triangle
what are the attachments of extensor digitorum
lateral epicondyle
splits into 4 tendons of each finger (under extensor retinaculum)
what are the attachments of the adductor pollicis muscles
transverse - metacarpal III
oblique - capitate/ metacarpal II and III
base of proximal phalanx
what muscles extend the shoulder joint (upper limb back in saggital plane)
posterior deltoid
lattisimus dorsi
teres major
what is the innervation of the levator scapulae
dorsal scapular nerve
what are the roots of the middle trunk
C7
what muscles weakly assist in the pronation of the radioulnar joints
flexor carpi radialis
palmaris longus
brachioradialis
what 2 bones in the upper limb does the scapula articulate with
clavicle
humerus
what is the lateral border of the cubital fossa
medial border of brachoradialis
what level does the axillary artery become the brachial artery
lower border of teres major muscle
what is the innervation of biceps branchii
musculocutanous nerve
where does the infraspinatis muscle originate
infraspinous fossa - below spine of scapula
what arteries arise from the superficial/ deep palmar arches to supply the digits
common palmar digital arteries
where are the thenar muscles located
base of thumb
what passes through the transverse and oblique heads of the adductor pollicis
radial artery
where are the pectoral group of lymph nodes
medial wall of axilla
receive from anterior thoracic wall including breast
what is the sensory function of the median nerve
lateral palm
lateral 3 1/2 fingertips on dorsal side
which area of the hand does the ulnar artery mainly supply
medial side of index finger and middle/ ring/ little finger
what nerve is contained in the carpal tunnel
median nerve
where can the brachial pulse be palpated
immediately medial to biceps tendon in the cubital fossa
what are the attatchments of flexor carpi radialis
medial epicondyle
base of metacarpal II and III
what is the sensory function of the musculocutaneous nerve
lateral cutaneous branch of the forearm
what forms the medial wall of the axilla
serrates anterior
thoracic wall
what are the attachments of the infraspinatus
infraspinatous fossa of the scapula
greater tubercle of the humerus
what are the muscles in the superficial compartment of the anterior forearm
flexor carpi ulnaris
flexor carpi radialis
palmaris longus
pronator teres
where does the long head of the triceps branchii attach
infraglenoid tubercle - inferior to glenoid fossa
what shape is the clavicle
S
what is the action of the subscapularis
medially rotates arm
what are the attachments of the rhomboid minor
spinous process of C7-T1
medial border of scapula
what is the innervation of extensor carpi ulnaris
radial nerve
what is the innervation of the anconeus
radial nerve
what is the main route of exit from the axilla
inferior & lateral into upper limb
what nerve is most likely to be damaged in a humeral surgical neck fracture
axillary
what 3 of the rotator cuff muscles attach to the greater tuberosity of the humerus
supraspinatus
infraspinatus
teres minor
what nerve would a mid shaft fracture of the humerus damage
radial nerve
profunda brachii artery
if the axillary nerve was damaged, what would the patent be unable to do
abduct the affected limb
what groove of the humerus does the radial nerve sit in
radial groove - lateral
what is the action of the teres minor
laterally rotates arm
What is the first branch of the brachial artery
profunda brachii - deep artery of arm
travels along posterior- supplies triceps
what are the nerve roots of the ulnar nerve
C8-T1 - medial cord
what is the innervation of extensor digitorum
radial nerve
what 3 muscles lies under the trapezius
rhomboid major
rhomboid minor
levator scpaulae
what is the sensory function of the ulnar nerve
medial 1/2 fingers and associated palm area
what is the name of the joint between the clavicle and the acromion
acromioclavicular
which is the largest and deepest of the thenar muscles
opponens pollicis
what part of the scapula articulates with the clavicle
acromion - projection from spine of scapula
what are the roots of the inferior trunk
C8-T1
what is the characteristic arm shape if the radial nerve is damaged
wrist drop (unopposed flexion at wrist) all posterior muscles affected - unable to extend forearm, wrist and fingers
what muscles protract the scapula (forward movement)
levator scapulae
serratus anterior
what muscles extend the elbow joint
triceps branchii
anconeus
what is the action of the supinator
supinate the forearm
where do the axillary lymph nodes drain
upper limb
pectoral region
what cord does the radial nerve come from
posterior (C5-T1)
what nerve innervates the pec minor
medial pectoral nerve
what group of ligaments forms the shoulder joint capsule and connects the humerus to the glenoid fossa
glenohumeral (superior, middle, inferior)
stabilise anterior aspect of joint
what is the name of the groove on the head of the humerus in between the lesser and greater tuberosity
inter tubercular groove
what is the innervation of the latissimus dorsi
thoracodorsal nerve
what does the median nerve supply in the hand
thenar muscle group
lateral 2 lumbricals
sensory - palmar skin, dorsal nail beds of lateral 3 1/2 digits
what are the attachments of the deltoid muscle
lateral spine of scapula and lateral 1/3 of clavicle
attaches to deltoid tuberosity on lateral surface of humerus
what is the medial border of the anatomical snuff box
tendon of extensor pollicis longs
what joints pronate and supinate the forearm
radioulnar
what bursa is inflamed in student elbow
subcutaneous olecranon
what is the action of pronator quadratus
pronate forearm
what is the innervation of extensor pollicis brevis
radial nerve
what is different about the clavicular joints compared to most synovial joints
lined with fibrocartilage instead of hyaline
is the biceps branchii attached to the humerus
no
why is the shoulder joint inheritidly unstable
head of humerus bigger than glenoid fossa
what are the nerve roots of the musculocutaneous nerve
C 5, 6, 7 - lateral cord
is the lesser tuberosity of the humerus seen on its anterior face or posterior face
anterior
what are the attachments of the teres major
posterior scapula to medial lip of inter tubercular groove of humerus
what epicondyle is inflamed in golfer’s elbow
medial epicondyle - common flexor
list the 8 carpal bones
scaphoid, lunate, triquetrum, pisiform
trapezium, trapezoid, capitate, hamate
what are the contents of the cubital fossa
radial nerve
biceps tendon
brachial artery
median nerve
what type of joint is the distal radioulnar joint
synovial pivot
what muscle is the main extensor of the fingers
extensor digitorum
what muscle does the brachial artery cross the cubital fossa under
brachialis
what are the 5 major branches of the brachial plexus
musculocutaneous nerve axillary nerve median nerve radial nerve ulnar nerve
what does the ulna articulate with distally
radius - radio-ulnar joint
what is the innervation of flexor carpi radials
median nerve
what are the attachments of flexor carpi ulnaris
medial epicondyle
into wrist to pisiform carpal bone
what type of joint is the elbow joint
synovial hinge
what is the motor function of the median nerve
most flexor muscles in forearm, thenar eminence, lateral 2 lumbircals (index and middle finger)
what factors contribute to the motility of the shoulder joint
ball and socket synovial
shallow glenoid cavity and large humeral head (golf ball and tee)
laxity of joint capsule
what is the action of the trapezius
superior - elevate scapula
middle - retract scapula
inferior - pull scapula inferiory
where does 75% of lymph from the breast drain
axilla
which shoulder bursa is most commonly inflamed (impingement syndrome)
subacromial
what is the function of the lumbricals
link extensor tendons to flexor tendons
what are the deep muscles of the posterior forearm
supinator
abductor pollicis longus
extensor pollicis longus/ brevis
extensor indicis
where does the median nerve travel in relation to the brachial artery
initially lateral then crosses to medial at the cubital fossa
which shoulder bursa communicated with the joint cavity
sub scapular
what type of joint is the acromioclavicular
synovial plane
what is the action of flexor carpi radials
flex wrist
abduction of wrist
what is the innervation of the supinator
radial nerve
what is the supra scapular artery a branch of
subclavian
what muscles flex the elbow joint
brachialis
biceps branchii
brachioradilais
what are the attachments of the teres minor
posterior scapula to greater tubercle of humerus
what 2 things lie in the radial groove (posterior humerus)
radial nerve
profunda brachii artery
what is the most commonly fractured bone in the hand
scaphoid
high risk of avascular necrosis and osteoarthritis
what muscle does the fibres of aconeus blend with
triceps branchii
which bone is the olecranon part of
proximal ulna
what are the 3 muscles in the deep compartment of the anterior forearm
flexor digitorum profundus
flexor pollicis longus
pronator quadratus
which of the 3 heads of the triceps is deepest
medial head
what muscles weakly assist in the supination of the radioulnar joints
extensor pollicis longus
extensor carpi radialis longus
what is the innervation of flexor digitorum superficialis
median nerve
what is the characteristic position of Klumpkes palsy
ulnar claw
does the basilic vein ascend up the arm on the medial or lateral side
medial
what two things articulate in the sternoclavicular joint
manubrium of sternum
sternal end of clavicle
what things may enlarge the axillary lymph nodes
infection of upper limb (normally humeral)
infection of pectoral region/ breast
metastasis of breast cancer
what type of joint is the glenohumeral (shoulder) joint
synovial ball and socket
what makes the floor of the anatomical snuff box
scaphoid and trapezium
what spinal segment does the triceps reflex test
C7
what 2 pronator muscles lie in there anterior forearm
pronator teres
pronator quadratus
what cord does the musculocutaneous nerve come from
lateral (C5 ,6, 7)
what are the attachments of the coracobrachialis
coracoid process of scapula
medial humeral shaft at deltoid tubercle
what forms the apex of the axilla
lateral border of 1st rib
superior border of scapula
posterior border of clavicle
what is the name of the groove on the head of the humerus in between the lesser and greater tuberosity
inter tubercular groove
where does the axillary nerve leave the axilla
quadrangular space - posterior wall
what are the attachments of flexor digitorum superficialis
medial epicondyle + radius
middle phalanges of 4 fingers
(through carpal tunnel)
what bursa becomes inflamed with excessive flexion and extension of the elbow (assembly line)
subtendinous bursitis
what elbow bursa is located within the tendon of the triceps branchii
intratendinous bursa
what forms the roof of the carpal tunnel
flexor retinaculum
tick connective tissue
what is the most superficial muscle in the pectoral region
pec major
where does the biceps branchii attach distally
biceps aponeurosis - radial tuberosity
where in the hand does the medial nerve supply sensory innervation
lateral 3 1/2 fingertips digits on the dorsum
associated palm area
what palsy occurs from trauma to the upper brachial plexus
Erb’s palsy
what are the 3 functions of the interosseous membrane
- hold radius and ulna together during pronation and supination (stability)
- site of attachment for muscles in the anterior and posterior compartments of the forearm
- transfers forces from the radius to the ulna
what muscles attach to the shaft of the humerus posteriorly
triceps medial and lateral head
what is the sensory function of the axillary nerve
lateral cutaneous brach of arm - regimental badge area
what is the 1st row of carpal bones
scaphoid, lunate, triquetrum, pisiform
where does the ulnar (medial) collateral ligament extend between
medial epicondyle to coronoid press and the olecranon of ulna
what palsy occurs from trauma to the lower brachial plexus
Klumpke
what is the action of the muscles of the anterior compartment of the arm
flexion of wrist and fingers
pronation of forearm
which area of the hand does the radial artery mainly supply
thumb and lateral side of index finger
where does the radial artery enter the hand
dorsal surface, crossing the anatomical snuffbox then turns medially to between the heads of adductor pollicis
what muscles extend and abduct/ adduct the wrist
extensor carpi ulnaris
extensor carpi radialis (longus and brevis)
what are the nerve roots of the posterior cord
C5-T1
what fossa forms the shoulder joint with the head of the humerus
glenoid fossa of scapula
what are the attachments of the serious anterior
lateral aspects of ribs 1-8
costal surface of scapula
what joins the radius and ulnar together between the radioulnar joints
interosseous membrane - sheet of connective tissue
what are the nerve roots of the radial nerve
C5- T1 - posterior cord
where does extensor carpi radialis brevis and longus originate and attach
brevis - lateral epicondyle
longus - supracondylar ridge
both attach to metacarpal II and III
what is the muscle in the intermediate compartment of the anterior forearm
flexor digitorum superficialis
what are the actions of the rhomboid major
retracts and rotates scapula
what articulates in the proximal and distal radioulnar joints
proximal - head of radius, radial notch of ulna
distal - ulnar notch of radius, ulnar head
what is the innervation of the deltoid muscle
axillary nerve
what are the actions of the lumbricals
flex at MCP joint
extend interphalangeal joints of each finger
what side of the cubital fossa doest he pronator teres form
medial border
where does the radius attach to the humerus
capitulum
what is the major joint that attaches the trunk to the upper limb
shoulder joint
what are the functions of the teres major
adducts shoulder
medially rotates arm
where does the right subclavian lymphatic trunk go
forms right lymphatic duct - enters right venous angle (junction of internal jugular and subclavian veins)
what are the functions of extensor carpi ulnaris
adduction of wrist
extend wrist
what is the action of the opponens pollicis
opposes thumb by medially rotating and flexing the metacarpal on trapezium
what are the functions of the pec minor
stabilise scapula by drawing it down and forwards against the thoracic wall
what are the 6 intrinsic shoulder muscles
deltoid teres major teres minor subscapularis infraspinatus supraspinatus
what is the 2nd (distal) row of carpal bones
trapezium, trapezoid, capitate, hamate
what is the motor function of the axillary nerve
teres minor and deltoid muscles
where is the superficial palmar arch in the hand
anterior to flexor tendons
deep to palmar aponeurosis
what 2 things are joined in the sternoclavicular joint
manubrium of sternum
sternal end of clavicle
what nerve innervates abductor pollicis brevis
median nerve
what are the functions of the pec major
adducts and medially rotates
draws scapula anteroinferiorly (depress scapula)
what vein runs in the roof of the cubital fossa
median cubital vein
how many dorsal and palmar interossei are there and why
4 dorsal
3 palmar - none on the middle finger - can’t adduct as in midline
where does the triceps attach to distally
tendon attaches to olecranon process of ulna
what are the main contents of the anatomical snuff box
radial artery
branch of radial nerve
cephalic vein
what is the action of extensor pollicis brevis
extends carpometacarpal and metacarpophalangeal joint of thumb
what are the 2 articulations in the elbow joint
trochlear notch of ulna and trochlea of humerus
head of radius and capitulum of humerus
what are the nerve roots of the lateral cord
C5, 6, 7
what nerve passes through the 2 heads of the supinator
deep branch of radial nerve
what nerve damage leads the the hand of benediction
median nerve - thenar eminence wasted, only little and ring finger can flex on fist
what is the innervation of the supraspinatus
suprascapualr nerve
what side of the humeral shaft is the deltoid tuberosity
lateral - attachment of deltoid
what 3 muscles attach to the lips of the intertubercuar groove of the humeral head
pectorals major
latissimus dorsi
teres major
(lady between 2 majors)
what spinal cord segment does the biceps tendon reflex test
C6
what ligaments aid the acromioclavicular joint
acromioclavicular - covers joitn capsule
conoid/coracoclavicular - vertically from coracoid process to combed tubercle of clavicle, very strong
what is the action of extensor carpi radialis longus/ brevis
extend and abduct wrist
what are the attachments of extensor carpi ulnaris
lateral epicondyle
attatched to base of little finger
what is the innervation of the triceps muscles
radial nerve
what muscles adduct the shoulder joint
pectorals major
teres major
latissimus dorsi
what type of joint is the sternoclavicular joint
synovial saddle
what is an extensor expansion
triangular tendinous aponeurosis that warps around the dorsum and sides of the metacarpal and base of proximal phalanx
what cord does the axillary nerve come from
posterior - only C5.6
what 2 things articulate in the acromioclavicular joint
lateral end of clavicle
acromion of scapula
what are the actions of the supraspinatus
abducts the arm 0-15
assists deltoid in abduction 15-90
what is the action of the flexor pollicis brevis
flexes metacarpophalangeal joint of the thumb
what muscles attach to the shaft of the humerus anteriorly
deltoid
brachialis
biceps branchii
coracobrachiaiis
what are the divisions of the brachial plexus
roots trunks divisions cords branches
what are the 5 main lymph groups of the axilla
pectoral subscapular humeral (lateral) central apical - top
what muscles share the same origin at the lateral epicondyle (extensor origin)
extensor carpi radialis brevis
extensor carpi ulnaris
extensor digitorum
extensor digiti minimi
what is the function of the lymphatic system
drain tissue fluid, plasma proteins and other cellular debris back into blood stream
what is the innervation of the teres minor
axillary nerve
what vein connects the basilica and cephalic veins at the elbow
median cubital vein
what are the actions of extensor digitorum
extends 4 fingers at MCP and IP joints
extends wrist
what surface is the cubital fossa on
anterior surface of the elbow joint
what is the innervation of the brachialis
musculocutanous nerve
what is the action of the levator scapulae
elevate scapula
what is the motor function of the ulnar nerve
flexor carpi ulnaris, medial half of flexor digitorum profundus
intrinsic muscles - hypothenar, medial 2 lumbircals, adducted polices, interossei and palmaris brevis
where does the coraco-acromial ligament run between
acromion and coracoid process of scapula
forms coraco-acromial arch over the shoulder arch
what are the nerve roots of the medial cord
C8-T1
which is the most common type of shoulder joint dislocation
anterior - excessive extension and lateral rotation
which is the most common carpal bone to fracture
scaphoid - tender anatomical snuffbox
what set of muscles attach to the medial epicondyle
forearm flexors
where do the deep lymph vessels terminate in the upper arm
axillary nodes
what forms the lateral wall of the axilla
intertubercular groove of humerus
what occurs in thoracic outlet syndrome
vessels and nerves becomes compressed between bones at the apex of axilla - between clavicle, 1st rib and scapula
which muscles extend or abduct the thumb
abductor pollicis longus
extensor pollicis brevis
extensor pollicis longus
what are the attachments of the supinator
lateral epicondyle and ulna
insert onto radius
what are the actions of flexor digitorum superficialis
flex metacarpophalangeal joints
flex proximal interphalangeal joints of 4 fingers
flex wrist
what are the branches of the medial cord
median nerve ulnar nerve medial pectoral nerve medial cutaneous nerve of arm medial cutaneous nerve of forearm
what forms the anterior wall of the axilla
pectorals major and minor
do any muscles act on the acromioclavicular joint
no- all movement passive
degree of axial rotation
where does the left subclavian lymphatic trunk go
directly into thoracic duct
what is the innervation of extensor pollicis longus
radial nerve
does the radius or ulna pivot with movement of the radio-ulnar joint
radius pivots around the ulnar
what does the brachial artery terminate into
ulnar and radial
what muscle and nerve damage leads to winging of the scapula
serratus anterior
long thoracic nerve
what 3 carpal bones form the wrist joint
scaphoid, lunate, triquestrum
what are the 2 functions of flexor capri ulnaris
flexion of wrist
adduction of wrist
what type of join is the wrist joint (radoiocarpal)
synovial ellipsoid (condyloid)
what nerve is compressed in carpal tunnel syndrome
median nerve
describe the transition of the subclavian artery
subclavian > axillary > brachial > ulnar/ radial > superficial palmar arch/ deep palmar arch
what are the attachments of flexor digitorum profundus
ulna
distal phalanges of 4 fingers
(through carpal tunnel)
what is an aneurysm
dilation of a blood vessel to more than twice its original size
where are the apical group of lymph nodes
apex of axilla - close to artery and vein
receive from central axillary lymph nodes - all lymph
what nerve innervates opponens pollicis
median nerve
where is the anatomical snuff box found
lateral aspect of dorsal of hand
where does the long head of the biceps branchi attach
supraglenoid tubercle - superior to glenoid fossa
does the extensor pollicis longus or brevis have a larger muscle belly
longus
what is the function of the middle fibres of the deltoid
abductor of arm - first 15 is supraspinatus
which ligament holds the long head of the biceps in the inter tubercular groove
transverse humeral ligament - between greater and lesser tubercles
what muscles flex the wrist
flexor carpi ulnaris
flexor carpi radialis
flexor digitorum superficialis
what are the 4 ligaments of the wrist joint (?)
ulnar collateral
radial collateral
dorsal radiocarpal
palmar radoiocarpal
what is function of the muscles in the posterior compartment of the arm
extension of the wrist and fingers
what side of the scapula does the supscapularis originate from
costal surface - subscapularis fossa
what is the innervation of flexor pollicis longus
median nerve
what is the only connection between the axial skeleton and the upper limb
sternoclavicular joint
where is the subacromial bursa
below deltoid and acromion, above the supraspinatus tendon and joint capsule
what type of joint is the acromioclavicular joint
synovial plane
what muscle attaches to the radial tuberosity
biceps branchii
what level does the subclavian artery become the axillary artery
lateral border of 1st rib
what 4 muscles are found in the pectoral region of the body
pec major
pec minor
serratus anterior
subclavius
where does the basilic vein become the axillary vein
combines with brachial veins at the border of tears major
what are the names of the veins that connect the superficial and deep venous drainage in the arm
perforating veins
how many phalanges are there
each finger has 3
thumb has 2 (14)
what is different about the thumb to the rest of the fingers
only distal and proximal phalanges
fingers have intermediate phalange
what deepens the glenohumeral joint to increase stabiltu
glenoid labrum - fibrocartilage rim
which vein in the upper arm is commonly used for venipuncture
median cubital
connects basilic and cephalic
is the conoid process of the clavicle near the sternal end or the acromial end
acromial
what are the actions of flexor pollicis longus
flexes interphalangeal joint of thumb
flexes metacarpophalangeal joint of thumb
what is the action of palmaris longus
flexion at wrist
what is the motor function of the radial nerve
triceps branchii
extensor muscles in posterior forearm
where does the short head of the biceps branchii attach
coracoid process of scapula
what muscles flex the shoulder joint (upper limb forward)
anterior deltoid
pectorals major
coracobrachialis
biceps branchii
where is the sub scapular bursa
between subscapularis tendon and scapula
what muscles attach to the extensor expansion
lumbricals
extensor indicis
dorsal and palmar interossei
what are the 2 anastomoses of the radial and ulnar arteries called
superficial palmar arch
deep palmar arch
what nerve innervates the palmar interossei
ulnar nerve
how many metacarpal bones are there in each hand
5
what is volkmann’s ischaemic contracture
uncontrolled flexion of the hand - flexors muscles fibrotic and short
interference with brachial artery
what is the function of the posterior fibres of the deltoid
extend arm at the shoulder
does flexor pollicis longus lie laterally or medially to flexor digitorum profundus
lateral
what does the proximal end of the ulna articulate with
trochlea of humerus
what forms the posterior wall of the axilla
scapularis
teres major
lattisimus dorsi
where is the hypothenar eminence
base of little finger
what muscle is the most powerful supinator of the forearm
biceps branchii
what are the 3 muscles in the anterior compartment of the upper arm
biceps branchii
brachialis
coracobrachialis
what muscles the adduct wrist
extensor carpi ulnaris
flexor carpi ulnaris
(ulnar deviation)
what normally happens to the radius when the ulnar is broken
also fracture/ dislocate (like a ring)
what does the axillary artery continue as and where
brachial artery
inferior border of trees major
what is the action of extensor pollicis longus
extends all thumb joints
carpometacarpal, metacarpophalangeal, interphalangeal
what are the attachments of pronator teres
medial epicondyle + coronoid process of ulna
mid shaft of radius
what are the actions of the coracobrachialis
flex arm at shoulder
weak adduction
what does the brachial artery bifurcate into
radial and ulna artery
what are the attachments of the rhomboid major
spinous process of T2-5
medial border of scapula
where are the sub scapular group of lymph nodes
posterior axillar
receive from posterior thoracic wall and scapular region
what are the superficial muscles of the posterior forearm
brachioradialis extensor cari radialis longus/ brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris ancones
how is movement produced at the proximal radioulnar joint
head of radius rotates within the annular ligament
what are the attachments of the pec minor
3-5th ribs
coracoid process of scapula
what side of the humeral head does the greater tuberosity lie
lateral
what does the subclavian artery continue as and where
axillary artery
lateral border of the 1st rib
what 3 muscles attach to the coracoid process of the scapula
pec minor
corachobrachialais
biceps branchii
what is the name of the 2 projections at the distal end of the humerus
lateral and medial epicondyle
what movements can occur at the shoulder joint
flexion, extension
adduction, abduction
medial/ lateral rotation
how would a mid shaft fracture of the humerus result in wrist drop
radial nerve innervates extensors of the wrist
what is the most common cause of tendonitis
overuse
what are the attachments of the trapezius
originates from skull, nuchal ligament and spinous process of C7-T12
attach to clavicle, acromion and scapular spine
where does the supraspinatus muscle originate
supraspinous fossa - above spine of scapula
what is the action of the triceps muscles
extension of the arm at the elbow
what is the most common fracture of the wrist and what happens
Colle’s fracture - fall onto outstretched hand
radius fracture +/- ulnar styloid process
dinner fork deformity
which of the epicondyles is the common flexor origin
medial
what do the superficial lymph vessels of the arm lie with
superficial veins
what arteries supply the shoulder joint
anterior and posterior circumflex humeral arteries
branches of axillary
what is the difference between the right and left subclavian artery
right - branch of brachiocephalic trunk
left - branch of arch of aorta
what happens in a monteggias fracture
force from behind ulna fractures proximal shaft, head of radius dislocates anteriorly at the elbow
which 3 muscles extend the medial 4 digits
extensor digitorum
extensor digiti minimi
extensor indicis proprius
does the cephalic vein ascend up the arm on the medial or lateral side
antero-lateral aspect of the arm
what muscles abduct the wrist
abductor pollicis longus
flexor carpi radialis
extensor carpi radialis longus/ brevis
what are the attachments of the supraspinatus
supraspinous fossa of scapula
greater tubercle of humerus
what muscle do the median nerve and ulnar artery pass under
flexor digitorum superficialis
what muscles abduct the shoulder joint
first 15 degrees- supraspinatus
middle deltoid does rest
past 90 the scapula needs to rotate
what ligament spans form the coracoid process to the greater tubercle of the humerus
coracohumeral ligament
what is the action of the infraspinatus
laterally rotate arm
what muscle in the posterior compartment is the exception to the extensor rule
brachioradialis
what factors contribute to the stability of the shoulder joint
rotator cuff muscles
glenoid labrum - fibrocartilaginous rim
ligmaents
biceps tendon
what are the names of the 2 classical fractures of the forearm
monteggia - proximal shaft of ulna
galeazzi - distal radius
where does the cephalic vein enter the axilla
clavipectoral triangle - anterior wall of axilla
what is the innervation of the coracobrachialis
musculocutanous nerve
where does the medial head of the triceps brachii originate
humerus, inferior to radial groove
what epicondyle is inflamed in tennis elbow
lateral epicondyle - common extensor
what are the branches of the posterior cord
axillary
radial
superior/ inferior sub scapular nerve
thoracodorsal nerve
what arteries supply the wrist joint
dorsal and palmar carpal arteries (branch of ulnar and radial)
what is the name of the tip of the humerus that sits posteriorly between the 2 epicondyles
trochlea
what rotator cuff muscle attaches to the lesser tuberosity of the humerus
subscapularis
what muscles retract the scapula (backwards movements)
trapezius
rhomboids
latissimus dorsi
what are the attatchments of the brachialis muscle
humeral shaft to coronoid process of ulna
what nerve injury leads to wrist drop
radial
what bones are involved in the radio-carpal joint
lunate, scaphoid
distal head of radius
what bones do the deep muscles of the posterior forearm act on (not supinator)
thumb
index finger
what is the innervation of the lumbricals
lateral - index and middle finger - median nerve
media; -pinky and ring finger - ulnar nerve
what do the lumbricals originate from
originate form tendon of flexor digitorum profundus
what nerve innervates the thenar muscles
median nerve
what are the groups of intrinsic muscles in the hand
thenar muscles
hypothenar muscles
lumbricals
interossei
how may lunate anterior dislocation manifest clinically
carpal tunnel syndromes
paraesthesia in sensory distribution of median nerve
weakness of thenar muscles
what are the attachments of the anconeus
lateral epicondyle to olecranon (all near elbow joint)
which of the rotator cuff muscles attaches to the lesser tubercle of the humerus
subscapularis
rest to greater tubercle
what is the characteristic sign of supraspinatus tendonitis
painful arc - pain in the meddle of abduction between 60-120 degrees - where affected area comes into contact with acromion
does pronation / supination occur at the elbow
no - radioulnar joint
what nerve may be damaged when taking a biopsy from the axilla lymph nodes
long thoracic nerve - winging of the scapula
what is the most common mechanism of a fracture of the clavicle
fall on the shoulder
fall on an outstretched had
what are the actions of the rhomboid minor
retracts and rotates scapula
what is the innervation of palmaris longus
median nerve
what are the attachments of flexor pollicis longus
radius to distal phalanx of thumb
what 9 tendons travel through the carpal tunnel
1 tendon of flexor polices longus (FPL)
4 tendons of flexor digitorum profundis (FDP)
4 tendons of flexor digitorum superficialis (FDS)
what are the 3 parts fo the clavicle
sternal end
shaft
acromial end
after the first 30 degrees abduction where does the majority of the movement occur
2 degrees shoulder joint, 1 degree scapula thoracic joint
2:1 scapula-humeral rhythm
what are the 2 most superficial back muscles
latissimus dorsi
trapezius
where does the long head of the triceps brachii originate
infraglenoid tubercle
what type of joint is the sternoclavicular joint
synovial saddle
what are the medial and lateral thickenings of the elbow joint capsule called
medial collateral ligament (ulnar)
lateral collateral ligament (radial)
what joint does the axilla lie underneath
glenohumeral
what do the deep veins of the arm run beside
paired veins run either side of the artery
pulsations assist in return
what are the attachments of the pec major
inter tubercular groove of humerus
clavicle head - medial 1/3
sternocostal head - sternum
what vein is a common site of venipuncture and why
median cubital vein
ease of access, fixed position, superficial position
what is the motor function of the musculocutaneous nerve
anterior compartment of arm - biceps branchii, brachialis, coracobrachialis
- flex upper arm at the shoulder and elbow, biceps supinate
does the radial artery supply the anterior or posterior forearm?
posterior
ulna anterior
where is the coracoid process of the scapula
originates from the superolateral costal side
hook like projection just under clavicle
what trunks form the medial cord
inferior
what do the deep lymph vessels of the upper limb follow
major deep veins - radial, ulnar and brachial
what is a characteristic sign of an ulnar nerve palsy
patients can’t grip paper placed between fingers
ulnar claw - hyperextension of MCPJ, flexion at IPJ
where does the long head of the biceps branchii attach
supraglenoid tubercle of scapula
what trunks form the posterior cord
superior, middle and inferior
what arteries branch off the axillary artery at the level of the humeral surgical neck
anterior and posterior circumflex humeral arteries - supply shoulder region
sub scapular artery
what is the innervation of pronator teres
median nerve
what is a bursa
synovial fluid sac
what is the difference between the intrinsic and extrinsic muscles of the shoulder
extrinsic - originate from the torso and attach to the clavicle/ scapula or humerus (superficial back)
intrinsic - originate form scapula/ clavicle and attach to the humerus
what shape is pronator quadratus
square
what is the difference in the mechanisms of a colle’s and smiths fractures
colles - fall onto outstretched hand
smiths - fall onto back of hand
what muscles pronate the proximal radioulnar joint
pronator teres, pronator quadratus
what position of the arm are the contents of the axilla most at risk of injury
arm sully abducted
what is the distal and proximal articulations of the wrist joint
distal - proximal row of carpal bones (scaphoid, lunate, triquetrum)
proximal - distal end of the radius
what part of the ulna does the brachialis muscle attach to
ulna tuberosity
what type of bone is the pisiform carpal bone
sesamoid bone - formed within the tendon of flexor carpi ulnaris
what movements can occur at the wrist joint
flexion, extension
adduction, abduction
circumduction
what is the action of the palmar interossei
Adduct the fingers
what type of cartilage lines the shoulder joint
hyaline cartilage
what muscles elevate the scapula
trapezius
leveator scapulae
rhomboids
what trunks form the lateral cord
middle and superior
what nerve innervates the dorsal interossei
ulnar nerve
what muscles laterally rotate the shoulder joint (away from midline, thumb point out)
infrapinatus
teres minor
what is the innervation of flexor carpi ulnaris
ulnar nerve
what are the 3 trunks formed by the roots of the brachial plexus
superior - C5-6
middle - C7
inferior - C8-T1
does the ulnar artery supply the anterior or posterior forearm?
anterior
radial posterior
what is the innervation of pronator teres
median nerve
what tissue layer are the deep veins in the arms situated
underneath deep fascia
where does the cephalic vein terminate
combines with axillary vein in the axilla
what are the major superficial veins of the upper limb
cephalic and basilic
located in subcutaneous tissue
what position is characteristic of erbs palsy
waiters tip - medial rotation and flexed wrists
what are the roots of the superior trunk
C5-6
what 3 muscles make up the thenar muscle group
opponens pollicis
abductor pollicis brevis
flexor pollicis brevis
what muscles will be affected in Klumpkes palsy
all intrinsic muscles of the hand
ulnar flexors of wrist and fingers
(T1)
what is the action of the abductor pollicis brevis
abducts the thumb
which 3 bones does the humerus articulate with
glenoid fossa of scapula
head of radius
trochlear notch of ulna
what way does the humeral head lie
medial
what ligament aids in the proximal radioulnar joint
annular radial ligament - forms collar around, reduces friction
what are the attachments of palmaris longus
medial epicondyle
flexor retinaculum of wrist
what is the function of the serrates anterior
rotates scapula - lateral and forward
where does lymph travel after the apical nodes
subclavian lymphatic trunk
what is the action of flexor digit minimi
flexes MCP joint of little finger
what is the lateral border of the anatomical snuff box
tendon of extensor pollicis brevis
tendon of abductor pollicis brevis
what are the attachments of the subscapularis
originates from sub scapular fossa (costal surface)
to lesser tubercle
what is the name given to the middle of the 2 forearm bones
interosseous membrane
what are the actions of flexor digitorum profundus
flex DIPJ
flex metacarpophalangeal joint
flex wrist
what are the 2 other muscles in the palm that are not thenar/ hypothenar/ interossei/ lumbricals
palmaris brevis
adductor pollicis
what is the superior border of the cubital fossa
imaginary line between medial an lateral epicondyles
where does the cephalic vein originate
lateral end of the dorsal venous arch
what is the innervation of the rhomboid muscles
dorsal scapular nerve
what is the innervation of the trapezius
accessory neve CN XI
what is the innervation of abductor pollicis longus
radial nerve
what happens on a galeazzis fracture
fracture to the distal radius, ulna head dislocates at radioulnar joint
what would occur if the axillary nerve was damaged in a patients
paralysis of deltoid and teres minor
difficulty performing abduction
sensation lost form regimental badge area
what is the action of the brachioradialis
flexes elbow
what muscles will be effected in Erb palsy
deltoid, teres minor
supraspinatus, infraspinatus
biceps branchii, brachialis, coracobrachialis
(C5/6)
what muscles laterally rotate the scapula (elevate glenoid cavity)
trapezius
serratus anterior
what is the innervation of the infraspinatus
supra scapular nerve
what muscles attach to the shaft of the clavicle
deltoid trapezius subclavian pectorals major sternocleidomastoid sternohyoid
what bones do the metacarpals attach with
proximal phalanges
carpal bones
what is the arterial supply to the triceps muscles
profunda brachii artery
what is the action of opponens digiti minimi
opposes little finger by rotating the metacarpal of little finger
what is the medial border of the cubital fossa
lateral border of pronator teres
what 2 carpal bones does the radius articulate with
scaphoid
lunate
what is the action of the dorsal interossei
ABduct the fingers
what nerve innervates flexor pollicis brevis
median nerve
what muscles attach to the superior surface of the olecranon
triceps branchii
how many carpal cones are there in each hand
8
what are the attatchments of the brachioradialis
proximal aspect of the lateral supcondylar ridge of the humerus
distal end of the radius
what set of muscles attach to the lateral epicondyle
forearm extensors
what is the purpose of synovial fluid
reduce friction between articulating structures
where are the lateral (humeral) group of lymph nodes
lateral wall of axilla
receive majority of lymph form upper limb
what is the action of the latissimus dorsi
extends arm
adducts arm
medially rotates arm - at the shoulder
what is the action of abductor pollicis longus
abducts the thumb
which nerve innervates the hypothenar eminence
ulnar nerve
what are the nerve roots of the median nerve
C6- T1 - lateral and medial
what is the innervation of extensor indices proprius
radial nerve
what muscles does the musculocutanous nerve pierce first on its course
coracobrachialis
what is the innervation of the subscapularis
subscapular nerve
what does the ulnar artery enter the hand between
anterior to flexor retinaculum
laterally to ulnar nerve
how does movement occur at the distal radioulnar joint
ulnar notch of radius slides anteriorly over head of ulnar
where are the central group of lymph nodes
base of axilla (deep to pec minor)
receive limb from efferent vessels from the pectoral, subscpular and humeral axillary lymph nodes
what network in the hand does the cephalic vein arise from
dorsal venous network
what is the action of abductor digiti minimi
abduct little finger
what nerves form the brachial plexus
ventral rami of C5-T1
what muscles supinate the proximal radioulnar joint
supinator, biceps branchii
what is the action of the brachialis muscle
flexion at elbow
what bone forms the floor of the carpal tunnel
scaphoid + trapezium
what are the attachments of the lattisimus dorsi
spinous processes of T6-12 . iliac crest
tendon attaches to inertubercular groove of humerus
what muscle forms the floor of the cubital fossa
brachialis
is the ulna involved in the wrist joint
no - prevented by articular disk (fibrocartilaginous ligament)
what are the contents of the axilla
axillary artery axillary vein brachial plexus biceps branchi & corachorachialis axillary lymph nodes
what is the glenohumeral joint and articulation between
head of humerus with glenoid cavity of scapula
what 3 nerves innervate the wrist
radial, median and ulnar
what is the only muscle that can flex the distal interphalangeal joints
flexor digitorum profundus
is the extensor digiti minimi medial or lateral to extensor digitorum
medial
what are the actions of the anconeus
extends elbow joint
abducts ulna during pronation of forearm
what nerves innervate the pec major
lateral and medial pectoral nerve
what muscles medially rotate the shoulder joint (towards midline, thumb point inward)
subscapularis anterior deltoid pectoralis major teres major latissimus dorsi
what are the nerve roots of the axillary nerve
C5, 6 - posterior cord
where does the clavicle extend from
sternum to acromion of scapula
what muscles medially rotate the scapula (depress the glenoid cavity
gravity leveator scapulae rhomboids pectorals major latissimus dorsi
what are the attachments of the extensor pollicis longus
posterior ulna/ interosseus membrane
distal phalanx of thumb
where does the basilic vein originate
medial end of the dorsal venous arch
what is a dermatome
the area of skin supplied by one spinal segment
what nerve innervates all the muscles in the posterior compartment of the arm
radial nerve
what bone does the trochlea of the humerus articulate with
trochlear notch of ulnar
what is the innervation of extensor carpi radialis longus/ brevis
radial nerve
