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MRCS Part A (KF edition) > Upper Limb Anatomy > Flashcards

Upper Limb Anatomy Flashcards

1
Q

What does the subclavian muscle do in relation to the clavicle and what is it innervated by?

A

It depresses the clavicle and is supplied by the upper trunk nerves

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2
Q

Where does the long head of the bicep insert?

A

Inserts into the Supraglenoid tubercle

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3
Q

Where does the long head of the tricep insert?

A

Infraglenoid tubercle

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4
Q

What are the 4 rotator cuff muscles where do they insert? (SITS)

A

Supraspinatus, Infraspinatus, Teres minor insert into the Greater Tubercle of the humerus. Subscapularus attaches to the Lesser Tubercle of the humerus

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5
Q

Which rotator cuff muscles are innervated by the Suprascapular nerve?

A

Supraspinatus, Infraspinatus and Subscapularis

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6
Q

What two structures are liable to damage at the surgical neck of the humerus?

A

Axillary nerve and Humeral circumflex artery

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7
Q

Where is the Capitulum located and what does it articulate with?

A

Capitulum is found on the lateral epicondyle of the humerus and articulates with the head of the radius

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8
Q

What articulates with the olecranon fossa?

A

Olecranon process of the ulnar bone

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9
Q

Where is the deltoid tuberosity found?

A

Posterior humerus

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10
Q

What are the carpal bones? (from lateral to medial)

A

Scared Lovers Try Positions That They Can’t Handle

Scaphoid - Lunate - Triquetrum - Pisiform
Trapezium - Trapezoid - Capitate - Hamate

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11
Q

Which flexor muscle attaches to the pisiform bone?

A

Flexor carpi ulnaris

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12
Q

Which carpal bone can be damaged in a FOOSH leading to median nerve injury?

A

Dislocation/damage to the Lunate can cause injury to median nerve

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13
Q

What are the origins of Trapezius muscle and what is its function?

A

Originates from C7-T12 spinal processes and causes Scapula rotation

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14
Q

What does the accessory nerve (CN XI) supply and how is it tested?

A

Supplies Trapezius muscle and Sternocledomastoid (SCM) muscle.

Tested by shrugging shoulders

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15
Q

Which nerve supplies Latismuss Dorsi?

A

Thoracodorsal nerve

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16
Q

Where does Pectoralis minor and major attach to?

A

Bicepital groove

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17
Q

What is the function of the Pectoralis major muscle and which nerves is it innervated by?

A

Causes internal rotation of the arm and ADDuction of the arm

Innervated by medial and lateral pectoral nerves

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18
Q

Where does Pectoralis minor originate from and what is its innervation?

A

Originates from ribs 3-5 and is innervated only by the medial pectoral nerve

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19
Q

What is the function of the Teres major and what is it supplied by?

A

ADDuction and internal rotation and EXTension of the arm

Supplied by the Lower SUBSCAPULAR nerve

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20
Q

Where does the Teres major originate and attach?

A

Originates at the Inferior Scapula and attaches medially on the humerus

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21
Q

Where is the Quadrangular space and what are its borders

A

Found below the shoulder joint adjacent to the surgical neck of the humerus

Superior: Teres minor
Inferior: Teres major
Medially: Long head of triceps tendon
Laterally: Humerus

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22
Q

What are the contents of the Quadrangular space?

A

Axillary nerve - Humeral artery - Posterior humeral circumflex artery

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23
Q

What is the origin and insertion of the Coracobrachialis and what is its function?

A

Originates at the coracoid and inserts into mid humerus

Allows for flexion and adduction of the arm

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24
Q

Which nerve innervates the Coracobrachialis?

A

Musculocutaneous nerve (lateral cord)

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25
Q

Which 3 muscles does the musculocutaneous nerve innervate?

A

BBC

Biceps brachii - Brachialis - Coracobrachialis

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25
Q

What does the musculocutaneous nerve become in the forearm and what does it supply?

A

Continues into the forearm as the Lateral Cutaneous Nerve and provides sensory sensation to the lateral forearm

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26
Q

What is the origin and insertion of Brachialis?

A

Originates from mid humerus and inserts into the ulna tuberosity anteriorly

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27
Q

What is the blood supply to the triceps?

A

Profunda brachii artery

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28
Q

Which nerve supplies the flexors of the forearm and which muscle is the exception?

A

All flexor forearm muscles are innervated by the median nerve EXCEPT Flexor carpi ulnaris

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29
Q

Which muscle is involved in flexion of the proximal interphalangeal (PIP) joint and where does it insert?

A

Flexor digitorum superficialis (FDS)

Inserts in the base of middle phalanges and splits to allow passage for Flexor digitorum profundus (FDP)

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30
Q

Flexor Digitorum Profundus allows for flexion of DIP. What is its nerve supply?

A

Median anterior interosseous nerve and Ulnar nerve

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31
Q

What are the 3 main deep flexors of the forearm?

A

Flexor digitorum profundus - Flexor pollicis longus - Pronator quadratus

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32
Q

What is the nerve supply of the deep flexors of the forearm?

A

Median anterior interossesous nerve

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33
Q

What are the 5 deep extensors of the forearm?

A
  • Supinator (inserts at dorsal lateral radius)
  • Abductor policies longus (1st metacarpal base)
  • Extensor policis brevis (inserts at prox thumb base)
  • Extensor pollicis longus
  • Extensor indices proprius (inserts at index finger)
34
Q

What is the nerve supply of the deep extensors of the forearm?

A

Radial-posterior interosseous nerve

35
Q

Which two extensors allow for extension of the wrist and where do they attach?

A

Extensor carpi radialis + Extensor carpi radialis brevis.

Insert into 2nd and 3rd metacarpal base respectively

36
Q

What are the attachments of the Extensor Retinaculum?

A

Pisiform and Triquetrum medially
End of radius laterally

37
Q

How many compartments are there beneath the extensor retinaculum?

A

5

38
Q

What are the boundaries of the anatomical snuffbox in relation to the compartments beneath the extensor retinaculum?

A

Anterolateral: Compartment 1 (Abductor pollicis longus and Extensor pollicis brevis)

Posteromedial: Compartment 3 (Extensor pollicis longus)

39
Q

What makes up the floor of the anatomical snuffbox?

A

Scaphoid and part of the Trapezium

40
Q

Inflammation in which muscles causes pain at the base of the thumb and what is the name of this condition?

A

De Querrvains tenosynovitis

Inflammation of Abductor pollicis longus and Extensore pollicis brevis

41
Q

Between which two muscles in the forearm does the radial nerve run?

A

Brachialis and Brachioradialis

42
Q

What are the 4 Thenar muscles and what are their innervations?

A
  • Abductor pollicis brevis (APB): Median nerve
  • Opponent pollicis: Median nerve
  • Flexor pollicis brevis (FPB): median and ulnar nerves
  • Adductor pollicis (deep ulnar nerve)
43
Q

Where are the extensor indices found?

A

Medial to Extensor digitorum within compartment 4 beneath the Extensor retinaculum

44
Q

Which structure splits pronator trees and runs between Flexor digitorum superficial (FDS) and Flexor digitorum profundus (FDP)?

A

Anterior Interosseous nerve

45
Q

What is the nerve root of the intrinsic muscles of the hand?

A

T1

46
Q

What is the function of the dorsal and palmar interossei?

A

DAB - Dorsal does Abduction
PAD - Palmar does Adduction

47
Q

How many dorsal and palmar interossei are there?

A

3 Palmar
4 Dorsal

48
Q

What are the nerve supplies of the lumbricals and and interossei?

A

Lumbricals: Median (lateral) and Ulnar (medial)
Interossei: Ulnar nerve

49
Q

What is the axillary artery a continuation of?

A

Subclavian artery

50
Q

What are the 3 main branches of the axillary artery?

A

Screw The Lawyer, Save A Patient

  • Superior thoracic artery (medial serrates and pectoral muscles)
  • Thoracoacromial artery (branches in Deltoid, Acromial, Pectoralis, Clavicular art.)
  • Lateral thoracic artery
  • Subscapular artery (gives rise to Thoracodorsal + circumflex scapular)
  • Anterior humeral circumflex (supplies humeral head)
  • Posterior humeral circumflex
51
Q

Where does the axillary artery become the brachial artery?

A

Lower border of Teres major

52
Q

What is the pathway of the median nerve in the upper arm?

A

Starts lateral to the brachial artery and crosses anteriorly over the mid humerus before continuing to the medial side of the brachial artery

53
Q

What structures does ulnar artery lie on at the wrist?

A

On the brachial and FDP superficial to the flexor retinaculum

54
Q

What are the branches of the ulnar artery?

A
  • Deep palmar arch
  • Superficial palmar arch
  • Anterior interosseous artery
55
Q

Which vein merges with the Basilic vein just prior to draining into the axillary vein?

A

Medial brachial vein

56
Q

Where is the brachial plexus located?

A

Posterior triangle of the neck between Scalene anterior and Medius muscles

57
Q

What are the roots of the brachial plexus?

A

C5-T1

58
Q

Which trunk of the brachial plexus is most likely to be damaged in a clavicle fracture?

A

Inferior trunk (C8-T1)

59
Q

What is the the nerve root of the Long thoracic nerve and what does it supply?

A

C5-7

Serratus anterior

60
Q

Where are cords of the brachial plexus found?

A

Axilla

Cords are labelled in relation to the axillary artery

61
Q

What are the 5 branches of the medial cord (C8-T1)

A

All begin with medial apart from 1

  • Medial pectoral nerve (supplies pec major)
  • Medial cutaneous nerve of the arm
  • Medial cutaneous nerve of the forearm
  • Medial part of median nerve
  • Ulnar nerve
62
Q

What are the 3 branches of the Lateral cord (C5-7)?

A
  • Lateral pectoral nerve
  • Lateral part of median nerve
  • Musculocutaneous nerve (supplies BBC)
63
Q

What are the branches of the Posterior cord (C5-T1)?

A

STARS

  • Subscapular (upper) nerve
  • Thoracodorsal nerve
  • Axillary nerve
  • Radial nerve
  • Subscapular (lower) nerve
64
Q

Which nerve gives sensation to the supraclavicular area?

A

Supraclavicular nerve (C4)

would remain intact in event of brachial plexus injury

65
Q

Which muscles in the hand are innervated by the Median nerve?

A

LOAF

Lateral 2 lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

66
Q

Which nerve supplies the forearm flexors and which addition muscles does this nerve supply in the arm?

A

All forearm flexors (except flexor carpi ulnas) are innervated by the median nerve

  • Pronator quadratus
  • Pronator teres
  • Palmaris longus
67
Q

Damage to which nerve would causes loss of pincer movement?

A

Anterior interosseous nerve

68
Q

What are the motor innervations of the ulnar nerve?

A

MAFIA P

  • Medial 2 lumbricals
  • Adductor pollicis
  • FDP + flexor carpi ulnaris
  • Interossei
  • Abductor and Opponens and Flexor digit minimi (hypothenar muscles)
  • Palmer’s brevis
69
Q

What effects would you expect to see after damage to the ulnar nerve at the wrist?

A
  • Loss of sensation in the medial hand
  • Wasting and paralysis of Hypothenar muscles and intrinsic muscles
70
Q

What would damage to the posterior interosseous nerve (PIN) cause?

A

Only finger drop

NO SENSORY LOSS

71
Q

Ulnar damage at which point of the arm would cause radial deviation of the hand and clawing of 4th and 5th fingers?

A

Damage to the ulnar nerve at the ELBOW

72
Q

What is the motor innervations of the radial nerve?

A

BEAST

Brachioradialis - Extensors - Aconeus - Supinator - Triceps

73
Q

Which rotator cuff muscle is responsible for 0-15 degrees abduction of the shoulder?

A

Supraspinatus

74
Q

What is the innervation of the breast?

A

Intercostal nerves (T4-6)

75
Q

What is the arterial supply of the breast?

A

Internal mammary artery (60%)
External mammary artery
Anterior intercostal arteries

76
Q

Where does the lymphatics from the breast drain into?

A

Axillary nodes

77
Q

What are the borders of the axilla?

A
  • Medially: Chest wall and Serratus anterior
  • Laterally: Humeral head
  • Floor: Subscapularis muscle
  • Anteriorly: Lateral border of Pec major
78
Q

Which nerves are at high risk for damage during a mastectomy?

A
  • Long thoracic nerve (C5-7)
  • Intercostal brachial nerve (parasthesia in armpits
  • Thoracodorsal nerve
79
Q

What are the medial and lateral boundaries of the cubital fossa?

A

Medial: Pronator teres
Lateral: Brachioradialis

80
Q

What structures are present in the Cubital fossa (medial to lateral)?

A

Median nerve - Brachial artery - Brachial vein - Biceps tendon - Radial nerve

81
Q

What is damaged in Erb’s palsy and what would a patient present with?

A

Damage to the Upper trunk (C5-6)

  • Loss of sensation in radial aspect of arm
  • Adduction and internal rotation of arm (due to paralysis of abductor muscles and infraspinatus and teres minor)
  • Forearm extension and pronation (due to paralysis of forearm flexors and supinators)
82
Q

VIT C & D

What are the 5 branches of the subclavian artery?

A

VIT C & D

  • Vertebral artery
  • Internal thoracic artery
  • Thyrocervical trunk
  • Costalcervical trunk
  • Dorsal scapular artery
83
Q

What is Klumbeks palsy?

A

Damage to the Lower trunk (C8-T1)

  • Loss of sensation in ulnar aspect of lower arm
  • Paralysis of all intrinsic muscles of hand
  • Paralysis of wrist flexors (except flexor carpi radialis)

MRCS Part A (KF edition) (18 decks)

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