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MSK > Upper Limb Anatomical Areas > Flashcards

Upper Limb Anatomical Areas Flashcards

1
Q

The axilla is an area that lies below the ________________ joint at the junction of the upper limb and ___________

A

Glenohumeral joint

Thorax

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2
Q

What general shape does the axilla have?

A

A pyramid shape - lateral wall, medial wall, anterior wall, posterior wall and apex

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3
Q

What is the apex of the axilla formed by? (3)

A

The lateral border of the first rib
The superior border of the scapula
The posterior border of the clavicle

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4
Q

What forms the lateral wall of the axilla?

A

The interturbercular groove of the humerus

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5
Q

What forms the medal wall of the axilla?

A

Serratus anterior and thoracic wall

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6
Q

What forms the anterior wall of the axilla?

A

Pectroalis major, pectoralis minor

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7
Q

What forms the posterior wall of the axilla?

A

Subscapularis, teres major and lattisimus dorsi

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8
Q

How does the size and shape of the axilla change with full abduction? What is the clinical significance of this?

A

Decreases in size when arm is fully abducted

The contents of the axilla are at most risk of injury when the arm is fully abducted

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9
Q

What are the contents of the axilla? (5)

A 
Medial and posterior parts of the axillary artery 
Axillary vein 
Brachial plexus 
Biceps brachii and coracobrachialis 
Axillary lymph nodes
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10
Q

What are the three main routes by which structures leave the axilla?

A

Immediately inferiorly and laterally into the upper limb

Quadrangular space

Clavipectoral triangle

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11
Q

Where is the quadrangular space?

A

In the posterior wall of the axilla

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12
Q

What structures pass through the quadrangular space?

A

The axillary nerve

Posterior circumflex humeral artery

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13
Q

Where is the clavipectoral triangle?

A

In the anterior wall of the axilla

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14
Q

The clavipectoral triangle is bounded by… (3)

A

The pectoralis major, deltoid and clavicle

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15
Q

What structures enter and leave through the clavipectoral triangle?

A

Cephalic vein enters the axilla

Medial and lateral pectoral nerves leave the axilla

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16
Q

What is thoracic outlet syndrome?

A

Where the nerves and vessels entering the axilla become compressed between the bones making up the apex

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17
Q

What are common causes of thoracic outlet syndrome? (2)

A

Trauma (e.g. Fractured clavicle)

Respective actions

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18
Q

How does thoracic outlet syndrome often present?

A

Pain in the affected limb, tingling, muscle weakness, discolouration

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19
Q

What can be biopsied in cases of suspected breast cancer? Why?

A

Axillary lymph nodes

Majority of the lymph from the breast drains here

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20
Q

What is axillary clearance?

A

Removal of the axillary lymph nodes to prevent the spread of cancer

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21
Q

The cubital fossa is located as a depression on the ____________ surface of the ________ joint

A

Anterior

Elbow

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22
Q

What shape does the cubital fossa have?

A

Triangular

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23
Q

What is the lateral border of the cubital fossa?

A

The medial border of the brachioradialis muscle

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24
Q

What is the medial border of the cubital fossa?

A

The lateral border of the pronation teres muscle

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25
Q

What is the superior border of the cubital fossa?

A

The imaginary line between the epicondyles of the humerus

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26
Q

What is the floor of the cubital fossa formed by?

A

Proximally by the brachialis

Distally by the supinator muscle

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27
Q

What forms the roof of the cubital fossa?

A

Skin and fascia and reinforced by the bicipital aponeurosis

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28
Q

What vessel runs in the roof of the cubital fossa? What is the clinical significance of this?

A

Median cubital vein

It can be accessed for venepuncture

29
Q

What are the contents of the cubital vessel? (4)

A

Radial nerve
Biceps tendon
Brachial artery
Median nerve

30
Q

The median cubital vein connects which two veins?

A

Basilic

Cephalic

31
Q

How can the brachial pulse be felt?

A

Palpating immediately medial to the biceps tendon

32
Q

How does a supracondylar fracture usually occur?

A

Falling on a flexed elbow

33
Q

A supracondylar fracture is a transverse fracture spanning between the two ______________

A

Epicondyles

34
Q

What is volkmann’s ischaemic contracture? What causes it?

A

Uncontrolled flexion of the hand as flexor muscles become fibrotic and short

Damage to the brachial artery causing ischaemia

35
Q

Which of the structures in the cubital fossa is most lateral?

A

Radial nerve

36
Q

The carpal tunnel is a narrow passageway found on the _________ surface of the _______

A

Anterior

Wrist

37
Q

The carpal tunnel is formed by which two layers?

A

A deep carpal arch

A superficial flexor retinaculum

38
Q

What forms the carpal arch laterally?

A

Scaphoid and trapezium tubercles

39
Q

What forms the carpal arch medially?

A

Hook of the hamate and the pisiform

40
Q

What is the flexor retinaculum? Where does it originate and insert?

A

Thick connective tissue forming the roof of the carpal tunnel

Originates on the lateral side and inserts on the medial side of the carpal arch

41
Q

What lines up with entrance of the carpal tunnel?

A

The distal wrist crease

42
Q

What nerve travels in the carpal tunnel?

A

Median nerve

43
Q

What tendons travel in the carpal tunnel?

A

Tendon of the flexor pollicis longus
4 tendons of the flexor digitorum profundus
4 tendons of the flexor digitorum superficialis

44
Q

How are the tendons covered in the carpal tunnel?

A

The 8 tendons are covered by a single synovial sheath

The tendon for the flexor pollicis longs has its own synovial sheath

45
Q

What is the purpose of sheaths surrounding the tendons?

A

Allows free movement of the tendons

46
Q

Once it passes through the carpal tunnel the median nerve divides into which 2 branches?

A

Recurrent branch

Palmar digital nerves

47
Q

The palmar digital nerves gives sensory innervation to…

A

The palmar skin and dorsal nail beds of the lateral three and a half digits

48
Q

The palmar digital nerves provide motor innervation to…

A

The lateral two lumbricals

49
Q

What does the recurrent branch supply?

A

The thenar muscle group

50
Q

What causes carpal tunnel syndrome?

A

Compression of the median nerve in the carpal tunnel

51
Q

If untreated carpal tunnel syndrome can result in?

A

Weakness and atrophy of the thenar muscles

52
Q

What can cause carpal tunnel syndrome?

A

Thickened ligaments and tendon sheaths

53
Q

What are some clinical features of carpal tunnel syndrome?

A

Numbness, tingling and pain in the distribution of the median nerve

54
Q

What test can be done for carpal tunnel syndrome?

A

Tinel’s sign - tapping the nerve in the carpal tunnel to elicit pain

55
Q

What is the treatment for carpal tunnel syndrome?

A

A splint holding the wrist in dorsiflexion overnight

Otherwise corticosteroid injections or surgical decompression

56
Q

Which branch of the median nerve is spared in carpal tunnel syndrome? Why?

A

Palmar cutaneous nerve

Given off prior to the carpal tunnel

57
Q

The anatomical snuffbox is located at the level of the __________ bones and is best seen when the thumb is ______________

A

Carpal

Abducted

58
Q

What forms the medial border of the anatomical snuffbox?

A

Tendon of the extensor pollicis longus

59
Q

What forms the lateral border of the anatomical snuffbox?

A

Tendons of the abductor pollicis longus and extensor pollicis brevis

60
Q

What forms the proximal border of the anatomical snuffbox?

A

The styloid process of the radius

61
Q

What forms the floor and roof of the anatomical snuffbox?

A

Scaphoid and trapezium

Skin

62
Q

What are the main contents of the anatomical snuffbox? (3)

A

Radial artery
Branch of the radial nerve
Cephalic vein

63
Q

Where does the radial artery pass in the anatomical snuffbox?

A

Crosses the floor in an oblique manner

64
Q

What pulse can be palpate in the anatomical snuffbox? How?

A

Radial pulse

Placing two fingers on the proximal portion of the anatomical snuffbox

65
Q

What branches of the radial nerve pass through the anatomical snuffbox? What do they innervate?

A

Terminal branches of the superficial branch of the radial nerve

The skin of the lateral 3 and a half digits on the dorsum of the hand and the associated palm area

66
Q

What two bones articulate in the anatomical snuffbox to form part of the wrist joint?

A

Scaphoid and the radius

67
Q

If localised pain is reported in the anatomical snuffbox what is the most likely cause?

A

Scaphoid fracture

68
Q

What most commonly causes scaphoid fracture?

A

FOOSH

69
Q

The blood supply of the scaphoid runs __________ to _________. What is the clinical significance of this?

A

Distal to proximal

Fracture can disrupt the blood supply in the proximal portion - if this isn’t revascularised it can result in avascular necrosis and future arthritis

MSK (10 decks)

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