Upper Limb Flashcards

1
Q

What three bones make up the pectoral girdle?

A

Clavicle
Scapula
Manubrium of sternum

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2
Q

What structures make up the four walls of the axilla?

A

Anterior wall- pectoralis major and minor, subclavius and their fascia
Posterior wall- teres major and latismuss dorsi
Medial wall- thoracic wall and serratus anterior
Lateral wall- intertubular sulcus of the humerus

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3
Q

What are the contents of the axilla?

A
Axillary artery and vein
Axillary lymph nodes
Parts of brachial plexus
Short head and long head of biceps brachii
Coracobrachialis
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4
Q

At what landmark does the subclavian artery become the axillary artery?

A

Lateral border of the first rib

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5
Q

At what landmark does the axillary artery become the brachial artery?

A

Inferior border of teres major

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6
Q

What two structures lie in the axillary sheath?

A

Axillary artery

Brachial plexus

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7
Q

What spinal nerves form the brachial plexus?

A

Ventral rami of C5-T1

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8
Q

What are the cords of the brachial plexus named in relation to?

A

The axillary artery

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9
Q

Which spinal nerves form what trunks of the brachial plexus?

A

Superior- C5 and C6
Middle- C7
Inferior-C8 and T1

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10
Q

What are the three cords of the brachial plexus?

A

Lateral
Posterior
Medial

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11
Q

Between which two muscles do the three trunks of the brachial plexus emerge from?

A

Scalenus medius and scalenus anterior

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12
Q

What are the terminal branches of the lateral cord of the brachial plexus?

A

Median (lateral root)
Musculocutaneous
Lateral pectoral

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13
Q

What are the terminal branches of the posterior cord of the brachial plexus?

A

Axillary
Radial
Thoracodorsal
Lower and upper subscapular

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14
Q

What are the terminal branches of the medial cord of the brachial plexus?

A
Ulnar
Median (medial root)
Medial pectoral
Medial cutaneous nerve of arm
Medial cutaneous nerve of forearm
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15
Q

What pathology does an injury to the upper trunk of the brachial plexus cause and what appearance does this give the arm?

A

Erb’s palsy

“Waiter’s tip”-medially rotates the arm and flexes the wrist

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16
Q

What kind of injury to the lower trunk of the brachial plexus would cause Klumpke’s palsy and what muscles would be affected by this?

A

Undue abduction of the arm

Intrinsic muscles of the hand and ulnar flexors of the wrist and fingers

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17
Q

Which cutaneous vein of the arm lies laterally?

A

Cephalic

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18
Q

What does the basilic vein join with to form the axillary vein?

A

Venae comitantes of the brachial artery

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19
Q

What are the five distinct groups of axillary lymph nodes?

A
Anterior/pectoral group
Posterior/subscapular group
Apical group
Central group
Lateral group
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20
Q

What are the three joints of the shoulder, what types of joint are these and what bones are articulating in them?

A

Glenohumeral-ball and socket synovial, scapula and humerus
Sternoclavicular- synovial saddle, sternum and clavicle
Acromioclavicular- synovial plane, scapula and clavicle

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21
Q

What are the two attachments of the trapezius?

A

External occipital protuberance

Spinous process of T12 vertebra

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22
Q

What are the actions of the trapezius?

A

Superior/descending fibres-elevate the scapula and when the scapula is fixed, they laterally flex the neck
Middle fibres- retract the scapula
Inferior/ascending fibres- depresses scapula
All fibres- act together to rotate the scapula and abduct the arm

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23
Q

What three muscles attach to the medial border of the scapula?

A

Levator scapulae

Rhomboid major and minor

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24
Q

What are the actions of Levator scapulae?

A

Elevates the scapula

Rotates the scapula

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25
What are the actions of rhomboid major and minor?
Retracts the scapula | Fixes scapula to thoracic wall
26
What are the actions of latissimus dorsi?
Extends, adducts and medially rotates the shoulder joint
27
What are the four rotator cuff muscles?
Teres minor Supraspinatus Infraspinatus Subscapularis
28
Is subscapularis anteriorly or posteriorly placed on the scapula?
Anteriorly
29
What are the actions of subscapularis?
Medially rotates shoulder joint | Adducts shoulder joint
30
What are the actions of supraspinatus?
Initiates abduction of the shoulder and helps deltoid
31
What is the action of teres minor and infraspinatus?
Laterally rotates the shoulder joint
32
What are the actions of teres major?
Adducts shoulder | Medially rotates shoulder
33
What are the three different parts of the deltoid muscle and what are their actions?
Clavicular- flexes and medially rotates shoulder joint Acromial- abducts shoulder joint Spinal- extends and laterally rotates shoulder joint
34
What is the acetabular labrum and what is its function?
The cartilage surrounding the socket | Keeps the head of humerus in place
35
What are the actions of pectoralis major?
Draws scapula anteriorly and inferiorly Adducts and medially rotates shoulder joint The clavicular head flexes shoulder joint and sternocostal head extends it from flexed position
36
What are the actions of pectoralis minor?
Stabilises the scapula by drawing it inferiorly and anteriorly
37
What are the actions of serratus anterior?
Protracts and rotates scapula
38
Which bursa of the shoulder communicates with the joint cavity, what is its role and what injury can damage it?
Subacromial bursa Facilitates movement of the supraspinatus tendon Shoulder dislocation
39
What three things make up the acromial arch?
Acromion Coracoid process Coraco-acromial ligament
40
What nerve is damaged if there is winging of the scapula seen?
The long thoracic nerve which causes paralysis of the serratus anterior muscle
41
What are the contents of the anterior arm and is it classed a flexor or an extensor compartment?
``` Brachial artery and venae comitantes Ulnar, median and musculocutaneous nerves Biceps brachii Coracobrachialis Brachialis Flexor compartment ```
42
To what parts of the scapula do the long and short head of biceps brachii attach to and how are they situated?
Short head lies medially and attaches to the coracoid process Long head lies laterally and attaches to the supraglenoid tubercle and runs in the bicipital groove of the humerus
43
What are the actions of biceps brachii?
Main supinator of forearm | When forearm is supinated, it flexes the elbow and shoulder joint
44
What are the attachments of coracobrachialis?
Coracoid process of scapula | Middle third of medial surface of humerus
45
What are the actions of coracobrachialis?
Flexes and adducts shoulder joint
46
What are the attachments of brachialis?
Proximal is the anterior surface of humerus | Distal is the coronoid process of the ulna
47
What are the actions of brachialis?
Flexes elbow joint in all positions
48
What is the continuation of the musculocutaneous nerve after it has supplied the anterior compartment of the arm?
Continues as the lateral cutaneous nerve of the forearm
49
Name an important branch pf the brachial artery that supplies the posterior arm?
Profunda brachii
50
Describe the position of the nerves of the anterior arm?
Median nerve runs medial to brachial artery before entering cubital fossa, giving off no branches. Ulnar nerve runs medial to brachial artery before entering the posterior arm
51
Name three areas of the humerus that if fractured could damage the axillary, ulnar and radial nerve?
Axillary-surgical neck Ulnar-medial epicondyle Radial-radial groove
52
What two muscles make up the medial and lateral borders of the cubital fossa?
Medial-pronator teres | Lateral-brachioradialis
53
What are the contents of the cubital fossa?
``` Brachial artery (splitting into R and U) Median nerve Radial nerve Median cubital vein Biceps brachii Tendon ```
54
What are the three attachments of triceps brachii?
Long head-infraglenoid tubercle of scapula Medial head-posterior surface of humerus, inferior to radial groove Lateral head-posterior surface of humerus, superior to radial groove
55
What are the actions of triceps brachii and what is its innervation?
Chief extensor of elbow joint Long head extends shoulder joint Radial nerve
56
What kind of joint is the elbow joint?
Hinge synovial
57
Which parts of the humerus and which parts of the ulna and radius articulate in the elbow joint?
The capitulum of the humerus articulates with the concave surface of the radius The trochlea of the humerus articulates with the trochlear notch of the ulna
58
What type of joints are the proximal and distal radio-ulnar joints?
Synovial pivot
59
What is the common flexor origin?
Medial epicondyle of the humerus
60
What are the four most superficial muscles of the anterior forearm?
Pronator Teres Palmaris Longis Flexor Carpi Radialis Flexor Carpi Ulnaris
61
What are the actions of the four most superficial muscles of the anterior forearm?
PT-Pronates and flexes forearm PL- Flexes hand at wrist FCR- Flexes and abducts hand at wrist FCU- Flexes and adducts hand at wrist
62
What is the innervation of the four most superficial muscles of the anterior forearm?
The median nerve innervates all of the muscles except the FCU which is innervated by the ulnar nerve
63
What are the actions of brachioradialis and what is its innervation?
Weak flexion of the elbow joint, maximal when forearm is mid-pronated position Radial nerve
64
What are the four muscles of the deep layer of the anterior forearm?
Flexor Digitorum Superficialis Flexor Digitorum Profundus Flexor Pollicus Longus Pronator Quadratus
65
What is the innervation and action of FDS?
Median nerve Flexes wrist joint Flexes proximal interphalangeal joints of middle four digits Flexes proximal phalanges at metacarpophalangeal joints
66
What is the innervation and action of the FDP?
``` Lateral part (digits 2 and 3) innervated by anterior interosseous branch of median nerve Medial part (digits 4 and 5) innervated by ulnar nerve Flexes wrist joint Flexes distal interphalangeal joints of digits 2 3 4 and 5 ```
67
What is the innervation and actions of FPL and PQ?
Innervated by anterior interosseous branch of median nerve FPL-flexes wrist and flexes both joints of thumb PQ-pronates forearm and the deep fibres bind the radius and ulna together
68
What are the contents of the carpal tunnel?
Median nerve Tendon of FPL 4 tendons of FDS 4 tendons of FDP
69
What bones make up the lateral and medial borders of the carpal tunnel?
Lateral-Scaphoid and trapezium | Medial-Pisiform and hamate
70
What muscle's tendons form the palmar aponeurosis?
Palmaris Longis
71
What are the four thenar muscles?
Opponens Pollicis Adductor Pollicis Abductor Pollicis Brevis Flexor Pollicis Brevis
72
What are the four thenar muscles and what is their actions on the thumb?
Opponens Pollicis- opposes Adductor Pollicis- adducts Abductor Pollicis Brevis-abducts Flexor Pollicis Brevis-flexes
73
What is the nerve supply to the thenar muscles?
Median nerve | Ulnar nerve supplies adductor pollicis
74
What are the three hypothenar muscles and what are their actions on the 5th finger?
Flexor Digiti Minimi-flexes proximal phalanx Abductor Digiti Minimi-abducts Opponens Minimi-draws it anterior and rotates it to bring it into opposition with the thumb
75
What is the nerve supply to the hypothenar muscles?
Ulnar nerve
76
From which muscle's tendons do the lumbricals originate?
Flexor Digitorum Profundus
77
What are the actions of the lumbrical muscles?
Flexes MCP joints | Extends IP joints of fingers 2-5
78
How many palmar and dorsal interossei are there?
Palmar-3 | Dorsal-4
79
What is the innervation of the interossei muscles?
Ulnar nerve
80
What are the actions of the interossei muscles?
Palmar-adducts fingers | Dorsal-abducts fingers
81
Which arteries are the main contributors to the superficial and deep palmar arches?
Superficial-ulnar | Deep-radial
82
Which nerve only innervates the hand cutaneously and is not involved in muscle innervation?
Radial
83
What kind of joint is the wrist joint?
Synovial condyloid
84
What are the five superficial muscles of the posterior compartment of the forearm and what are their actions?
Extensor carpi Radialis Longus-Extend and abduct wrist joint Extensor carpi Radialis Brevis-Extend and abduct wrist joint Extensor Digitorum-Extend wrist joint and extends medial four fingers at MCPJ and IPJ Extensor Digiti Minimi-Extends wrist joint and extends thumb at MCPJ and IPJ Extensor Carpi Ulnaris-Extends and adducts wrist
85
What is the innervation of the five superficial muscles of the posterior compartment of the forearm?
Radial nerve
86
What is the common extensor origin?
Lateral epicondyle
87
What are the four deep muscles of the posterior forearm and what are their actions?
Abductor Pollicis Longus- extends wrist joint and abducts thumb and extends it at MCPJ Extensor Pollicis Longus-extends wrist joint and extends at all joints of thumb Extensor Pollicis Brevis- extends wrist joint and extends at MCPJ and CMCJ of thumb Extensor Indicis-extends wrist joint and 2nd finger
88
What is the innervation of the deep muscles of the posterior forearm?
The posterior interosseous nerve (continuation of the deep branch of the radial nerve)
89
What are the two carpal bones felt in the anatomical snuff box?
Scaphoid | Trapezium
90
From what muscles tendons do the extensor expansions come from?
Extensor Digitorum