Upper Limb Anatomy Flashcards
Supply of Brachial Plexus
C5-8 and T1
Position of subclavian vessels in relation to scalene muscles
Artery posterior to scalene anterior, vein anterior to scalene anterior
Supply of Brachial Cords
Lateral: Ant branches of upper and middle trunks
Medial: Ant Division of lower trunk
Posterior: Post division of all cords
Cords forming medial nerve
Lateral + branch of medial
Cords forming ulnar nerve
Medial
Cords forming radial nerve
Posterior
Klumpke’s Paralysis
C8/T1 Lesion
Claw hand, medial loss of sensation and Horner’s
Ulnar Nerve Path
Descends on posteriomedial aspect of humerus. Passes between humeral and ulnar heads into anterior compartment. Passes into hand through Guyon’s canal.
Muscles supplied by ulnar nerve
Flexor carpi ulnaris, Flexor digitorum profundus, Flexor digiti minimi, Abductor digiti minimi, Opponens digiti minimi, Adductor pollicus, 3/4th Lumbricals, palmaris Brevis
Ulnar nerve sensory innervation
Fifth digit plus medial side of fourth (Palmar surface)
Result of ulnar lesion at elbow
Claw hand, ulnar sensory deficit
Result of ulnar lesion at wrist
Claw hand less prominent. Ulnar sensory deficit
Median nerve Path
Courses along lateral, then medial surface of brachial artery, passes below flexor retinaculum in forearm.
Median nerve branches in forearm
Anterior Interosseous, Palmar Cutaneous
Median Nerve Muscle Supply
Pronator Teres, Flexor Carpi Radialis, Palmaris Longus, Flexor digitorum profundus, Flexor digitorum superficialis, Flexor pollicus longus, Lateral lumbricals, opponens Pollicus, Abductor Pollicus Brevis, Flexor pollicus brevis (LOAF)
Median nerve Sensation
Thumb, index and middle finger. Lateral half of ring finger. (Palm supplied by palmar cutaneous branch)
Upper arm median nerve injury
Loss of pronation, hand flexion, thumb abduction and sensation over median distribution
Carpal tunnel injury
Loss of sensation over median distribution of hand (NOT palm, as palmar cutaneous leaves prior to canal)
Anterior Interosseous Nerve
Branch of median nerve. Supplies flexor digitorum proufundus, flexor pollicus longus and pronator. Injury caused by tight forearm cast
Radial nerve path
Passes medial to lateral in spiral groove of humerus. Passes anterior to lateral epicondyle. Terminates at superficial and deep branches
Muscles supplied by radial nerve
Triceps, brachioradialis, extensor carpi radialis longus / brevis, Supinator, Extensor digitorum, Extensor digiti minimi, Extensor carpi ulnaris / radialis, Abductor pollicus longus, Extensor pollicus brevis / longus, Extensor indicis, (BEST)
Musculocutaneous Nerve Origin
Branch of lateral cord
Muscles of musculocutaneous nerve
Coracobrachialis, Biceps brachii, Brachialis (BBC)
Musculocutaneous nerve injury
Weak elbow flexion / supination
Erb’s Palsy
C5/6 lesion resulting in pronation and medial rotation.
Origin of Subclavian
Right: Brachiocephalic
Left: Aorta
Branches of Subclavian
Internal Thoracic, Vertebral, Thyrocervical trunk, Costocervical trunk, Doorsal Scapular Artery
End of subclavian artery
Border of first rib
Branches of thyrocervical trunk
Inferior thyroid, Supra-scapular, Transverse cervical
Borders of axillary artery
Start: First rib
End: Lower border trees minor
Brachial Artery Path
Begins lower border trees minor
Passes medial to biceps tendon
Profunda Brachii Supply
Deltoid and triceps
Profunda Brachii Path
Follows radial nerve along humeral groove to reach lateral epicondyle
Deltoid Muscle
Origin: Lateral clavical, acromion and scapula Insertion: Deltoid tuberosity of humerus Innervation: Axilary nerve Artery: Ant + Post. Humeral Circumflex Action: Shoulder abduction
Brachioradialis
Origin: Lateral humerus Insertion: Distal radius Innervation: Radial Artery: Radial recurrent Action: Elbow flexion
Biceps
Origin: Coracoid process of scapula / Supraglenoid tubercle
Insertion: Radial tuberosity / Bicipital aponeurosis
Innervation: Musculocutaneous nerve
Artery: Brachial
Action: Elbow flexion / Supination / Shoulder Abduction
Triceps
Origin: Infra gelnoid tubercle / above/ below radial sulcus
Insertion: Olecranon of ulna
Innervation: Radial
Artery: Deep brachial
Action: Extends elbow / extends should / adducts arm
Supinator
Origin: Lateral humeral epicndule / ulna Insertion: Lateral radial shaft Innervation: Radial Artery: Radial Action: Supination
Pronator Teres
Origin: Humeral / Ulnar Head Insertion: Middle / Lateral Radius Innervation: Median Artery: Ulnar Action: Pronation
Palmaris Longus
Origin: Medial Epicondyle Insertion: Palmar Aponeurosis Innervation: Median Artery: Ulnar Action: Wrist flexion
Coracobrachialis
Origin: Coracoid process of scapula Insertion: medial humerus Innervation: Musculocutaneous Artery: Brachial Action: Adduction
Infraspinatus
Origin: Infraspinatous fossa of scapula Insertion: Humeral greater tubercle Innervation: Suprascapular nerve Artery: Supra and circumflex scapular nerve Action: Lateral rotation of shoulder
Latissimus Dorsi
Origin: Spinous process of T7 to L5, Iliac crest
Insertion: Intertubercular groove of humerus
Innervation: Thoracodorsal
Artery: Subscabular
Action: Adducts, extends and internally rotates shoulder
Pectoralis Minor
Origin: Ribs 3-5 Insertion: Coracoid process of scapula Innervation: Medial Pectoral Artery: Thoracoacromial trunk Action: Stablises scapula
Pectoralis Major
Origin: Clavicular and sternocostal head Insertion: Bicipital groove of humerus Innervation: Lateral and medial pectoral nerve (brachial plexus) Artery: Thoracoacromial trunk Action: Flexes and extends humerus
Subscapularis
Origin: Subscapular fossa Insertion: Humeral lesser tubercle Innervation: Upper/Lower Subscapular nerve Artery: Subscapular Action: Shoulder internal rotation
Supraspinatous
Origin: Supraspinatous Fossa Insertion: Humeral greater tubercle Innervation: Suprascapular Artery: Suprascapular Action: Abduction
Teres Major
Origin: Inferior scapular Insertion: Intertubecular Sulcus Innervation: Subscapular nerve Artery: Subscapular Action: Internal rotation
Teres Minor
Origin: Lateral scapular Insertion: Greater tubercle Innervation: Axillary Artery: Posterior circumflex humeral Action: External rotation
Anconeus
Origin: Lateral Epicondyle Insertion: Olecranon of ulna Innervation: Radial Artery: Brachial Action: Assists with extension of elbow