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