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MRCS part A > Upper Limb Anatomy > Flashcards

Upper Limb Anatomy Flashcards

1
Q

What is the path of the musculocutaneous nerve?

A

Branch of lateral cord of brachial plexus.
- penetrates coracobrachialus muscle
- passes obliquely between Biceps Brachii and Brachialis to the lateral side of the arm
- Pierces deep fascia lateral to the tendon of the biceps brachii ABOVE the elbow
- Continues into the forearm as the Lateral Cutaneous Nerve of the forearm

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2
Q

What 3 muscles are innervated by the musculocutaneous nerve?

A
  • Coracobrachialis
  • Biceps brachii
  • Brachialis
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3
Q

What 3 muscles make up the Thenar Eminence?

A
  • Abductor pollicis brevis
  • Opponens pollicis
  • Flexor pollicis brevis

Innervated by median nerve

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4
Q

What 3 muscles make up the Hypothenar eminence?

A
  • Opponens digiti minimi
  • Flexor digiti minimi brevis
  • Abductor digiti minimi
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5
Q

What is the relation of the Serratus Anterior to the Long thoracic nerve?

A

The muscle lies MEDIAL to the Long Thoracic Nerve

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6
Q

What flexors in the forearm are innervated by the median nerve?

A

Flexor carpi radialis
Flexor digitorum superficialis
Flexor pollicis longus
Flexor digitorum profundus (radial half)

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7
Q

What is the motor supply of the median nerve in the hand?

A

LOAF
- Lateral 2 lumbricals
- Opponens pollicis
- Abductor pollicis brevis
- Flexor pollicis brevis

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8
Q

What does damage to the median nerve at the elbow result in?

A
  • unable to pronate forearm
  • weak wrist flexion
  • ulnar deviation of wrist
  • signs of carpal tunnel syndrome
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9
Q

What muscles of the forearms are innervated by the Radial Nerve (Posterior interosseous branch)?

A
  • Supinator
  • Brachioradialis
  • Extensor carpi ulnaris
  • Extensor pollicis longus AND brevis
  • Abductor pollicis longus
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10
Q

What nerve lies laterally to the brachial artery at the level of the proximal humerus?

A

Median nerve

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11
Q

What are the borders of the anatomical snuffbox?

A
  • Posterior (medial): Extensor pollicis longus
  • Anterior: Extensor pollicis brevis and longus
  • Proximal: Styloid process of radius
  • Distal: apex of triangle
  • Floor: Scaphoid and trapezium

Contains the radial artery

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12
Q

What are the clinical symptoms associated with ulnar damage at the elbow?

A
  1. Radial deviation of the wrist
  2. Clawing less in 4th and 5th digits
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13
Q

What are the 6 branches of the axillary artery?

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A

1st part
- Superior thoracic artery

2nd part
- Thoracoacromial artery
- Lateral thoracic artery

3rd part
- Subscapular artery
- Anterior humeral circumflex artery
- Posterior humeral circumflex artery

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14
Q

What are the attachments of the Extensor retinaculum?

A
  • Attaches at the pisiform and triquetral medially
  • End of the radius laterally
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15
Q

What structures lie superficial to the Extensor retinaculum?

A
  • Basilic vein
  • Cephalic vein
  • Dorsal cutaneous branch of ulnar
  • Superficial branch of the radial
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16
Q

What structures pass deep to the extensor retinaculum?

A

Medial to lateral

  • Extensor carpi ulnaris
  • Extensor digiti minimi
  • Extensor digitorum and extensor indicis
  • Extensor pollicis longus
  • Extensor carpi radialis longus
  • Extensor carpi radialis brevis
  • Abductor pollicis longus and Extensor pollicis brevis
17
Q

What are the nerve roots of the median nerve?

A

C5-T1

18
Q

What are the nerve roots of the axillary nerve?

A

C5 and C6

19
Q

What is the path of the axillary nerve?

A
  • Descends posterior to the axillary artery at lower border of subscapularis
  • Passes through Quadrangular space with Posterior circumflex humeral vessels
  • Divides into anterior and posterior branches
20
Q

What are the nerve roots of the ulnar nerve?

A

C8, T1

21
Q

What is supplied by the Deep branch of the ulnar nerve?

A
  • Hypothenar muscles
  • All interosseous muscles
  • 3rd and 4th lumbricals
  • Adductor pollicis
  • Medial head of flexor pollicis brevis
22
Q

What is a C5, C6 root lesion commonly known as and how does it present?

A

Erb’s palsy

  • Loss of shoulder abduction (deltoid and supraspinatus paralysis)
  • Loss of external rotation (infraspinatus paralysis)
  • Loss of elbow flexion (biceps, brachialis, brachioradialis paralysis)
  • Loss of forearm supination
23
Q

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

A

As it crosses the lateral border of the first rib

24
Q

What is the pathophysiology of Subclavian steal syndrome, how does it present and how is it treated?

A

Subclavian artery steno-occlusive disease PROXIMAL to origin of vertebral artery and is associated with flow reversal in the vertebral artery

Symptoms:
- dizziness (esp on exertion of arm)
- vertigo (esp on exertion of arm)
- arm pain

Management:
- percutaneous transluminal angioplasty
- stent

25
Q

What are the important anatomical relations of the shoulder joint?

A

Anteriorly:
- Brachial plexus
- Axillary artery and vein

Posteriorly:
- Suprascapular nerve and vessels

Inferiorly:
- Axillary nerve
- Circumflex humeral vessels

26
Q

How does the Fibrous capsule attach to the scapula and humerus?

A

Postero-superiorly:
Attached to the Scapula external to the glenoid labrum and to the labrum itself

Attaches to the humerus at the level of Anatomical neck SUPERIORLY and the Surgical neck INFERIORLY

27
Q

From which structure does the long head of the triceps arise?

A

Infraglenoid tubercle

28
Q

What are the borders of the quadrangular space and what does it transmit?

A

Laterally: Humerus
Superiorly: Subscapularis and teres minor
Inferiorly: Teres major
Medially: Long head of triceps

Transmits Axillary nerve and Posterior circumflex humeral artery

29
Q

What nerve innervates the skin overlying the skin?

A

Intercostobrachial nerve

Traverses the axilla and can be injured during axilla surgery

30
Q

What is the path of the thoracoacromial artery and what do it’s 4 branches supply?

A

Arises from the forepart of the axillary artery, pierces the coracoclavicular fascia before dividing into its 4 branches

1- Pectoral branch: supplies the 2 pectoral muscles and the breast

2- Acromial branch: runs laterally over the voracious process and under the deltoid

3- Clavicular branch: runs upwards and medially to the sternoclavicular joint supplying this articulation

4- Deltoid branch: crosses Pec minor and passes in the same groove as the cephalic vein (between Pec Major and deltoid)

31
Q

Where does the musculocutaneous nerve lie in the distal third of the upper arm?

A

Lies between the Biceps brachii and Brachialis muscles

32
Q

What are the 8 muscles of the thumb?

A
  1. 2 flexors (flexor pollicis brevis and longus)
  2. 2 extensors (extensor pollicis brevis and longus)
  3. 2 abductors (abductor pollicis brevis and longus)
  4. 1 adductor (adductor pollicis)
  5. Opponens pollicis (opposes thumb)
33
Q

Where does the scaphoid bone derive the majority of its blood supply?

A

Dorsal carpal branch vessels (via retrograde flow)

34
Q

What 3 muscles attach to the upper third of the radius?

A
  • Supinator
  • Flexor digitorum superficialis (FDS)
  • Flexor pollicis longus (FPL)

MRCS part A (9 decks)

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