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MRCS Anatomy > Upper Limb Anatomy > Flashcards

Upper Limb Anatomy Flashcards

1
Q

Branches of the axillary artery (classified by parts of axillary artery) (6)

A 
1st part (medial to pec minor) = 1 branch: superior thoracic artery
2nd part (behind pec minor) = 2 branches: thoracoacromial trunk, lateral thoracic artery
3rd part (lateral to pec minor) = 3 branches: subscapular artery, anterior circumflex humeral artery, posterior circumflex humeral artery
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2
Q

Contents of the axilla (5)

A 
Axillary artery + branches
Axillary vein + tributaries
Brachial plexus
Lymph nodes
Fat
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3
Q

Borders of the axilla (5)

A 
Anterior = pec major and minor
Medial = serratus anterior, upper three ribs and intercostals
Posterior = subscapularis, teres major, lat dorsi (superior to inferior)
Lateral = intertubercular (bicipital) groove of humerus, short head of biceps, coracobrachialis tendon
Base = axillary fascia
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4
Q

Regions of brachial plexus (5)

A

Roots, Trunks, Divisions, Cords, Branches

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5
Q

Branches of lateral cord of brachial plexus (3)

A

Lateral pectoral nerve
Musculocutaneous nerve
Part of median nerve

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6
Q

Branches of medial cord of brachial plexus (5)

A 
Medial pectoral nerve
Medial cutaneous nerve of arm
Medial cutaneous nerve of forearm
Part of median nerve
Ulnar nerve
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7
Q

Branches of posterior cord of brachial plexus (5)

A 
Upper subscapular nerve
Thoracodorsal nerve
Lower subscapular nerve
Axillary nerve
Radial nerve
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8
Q

Where does dorsal scapular nerve arise from? (1) What does it serve? (3)

A

Arises from C5 root

Serves rhomboid major, rhomboid minor, levator scapulae

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9
Q

Where does long thoracic nerve arise from? What does it serve? (1)

A

Arises from C5-7

Serves serratus anterior

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10
Q

Where does nerve to subclavius arise from?

A

Upper trunk of brachial plexus (C5-6)

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11
Q

Where does suprascapular nerve arise from? What does it serve? (2)

A

Arises from upper trunk of brachial plexus (C5-6)

Serves supraspinatus and infraspinatus

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12
Q

What structures are at risk when surgical neck of humerus fractured? (2)

A

Axillary nerve
Posterior circumflex humeral artery
(both are close to surgical neck in quadrangular space)

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13
Q

What structure is at risk when midshaft humerus is fractured? Why?

A

Radial nerve
Lies in radial groove (AKA spiral groove/musculospiral groove/radial sulcus), which is midshaft, lateral, inferior to deltoid tuberosity

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14
Q

Where is the coronoid fossa located?

A

Superior to trocholea, medial to radial fossa (anterior surface of distal humerus)

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15
Q

Where is the radial notch located?

A

Lateral aspect of coronoid process (proximal ulna)

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16
Q

Is radial head distal or proximal?

Is head of the ulna distal or proximal?

A

Radial head proximal

Ulnar head distal

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17
Q

What inserts into the radial tuberosity?

A

Tendon of the biceps brachii

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18
Q

Where is Lister’s tubercle?

What is its function?

A

Distal end of radius, dorsal aspect (AKA dorsal tubercle)

Acts as pulley for EPL tendon to change direction

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19
Q

Subclavius muscle:

  1. Origin?
  2. Insertion?
  3. Function?
A
  1. Superior surface of medial end of first rib and its cartilage
  2. Inferior surface of middle third of clavicle
  3. Depresses clavicle, elevates first rib
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20
Q

What provides majority of stability to ACJ?

A

Costoclavicular ligament

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21
Q

What elevates the shoulder girdle?

A

Levator scapulae, upper fibres of trapezius

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22
Q

What depresses the shoulder girdle?

A

Lower fibres of trapezius, subclavius, lat dorsi, pec minor

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23
Q

What protracts the shoulder girdle?

A

Serratus anterior, pec minor, pec major

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24
Q

What retracts the shoulder girdle?

A

Trapezius, rhomboids major and minor

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25
Q

What are the origins and insertions of:

  1. Upper fibres of trapezius? (3,3)
  2. Lower fibres of trapezius? (1,1)
A
  1. Origins = External occipital protruberance, superior nuchal line, spines of cervical vertebrae
    Insertions = inner border of acromium, outer third of clavicle, spine of scapula
  2. Origins = spines of thoracic vertebrae
    Insertions = medial spine of scapula
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26
Q

What are the origins and insertions of levator scapulae?

A 
Origins = transverse processes C1-4
Insertions = Supero-medial angle of scapula
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27
Q

What are the origins and insertions of rhomboids major and minor?

A 
Origins = spines of upper thoracic vertebrae
Insertions = vertebral border of scapula
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28
Q

What are the origins and insertions of serratus anterior?

A 
Origins = upper 8 ribs
Insertions = vertebral border of scapula
29
Q

What provides active and passive stability to the GHJ? Which is the most important?

A

Passive:
Glenoid labrum
Capsule thickened by 2 glenohumeral ligaments anteriorly and coracohumeral ligament superiorly

Active
Tendon of long head of biceps (from supraglenoid tubercle, through bicipital groove
Rotator cuff muscles (most important)

30
Q

What are the borders of the quadrangular space? (4)

Contents? (2)

A 
Borders: 
Superior = teres minor
Inferior = teres major
Lateral = humerus
Medial = long head of triceps

Contents:
Axillary nerve
Posterior circumflex humeral artery

31
Q

Which muscles flex the shoulder?

A

Pec major and anterior deltoid are prime movers

Biceps brachii and coracobrachialis mainly stabilise

32
Q

Which muscles extend the shoulder?

A

Lat dorsi and posterior deltoid

Teres minor and major assist

33
Q

Which muscles adduct the shoulder?

A

Prime = pec major, lat dorsi

Subscapularis assists

34
Q

Which muscles abduct the shoulder? (4 separate stages)

A

First 10-15 deg = supraspinatus
10-90 deg = deltoid
>90 deg needs rotation of scapula (trapezuis and serratus anterior) and lateral rotation of humerus (subscapularis, teres major, infraspinatus)

35
Q

Which muscles medially rotate the shoulder?

A 
Pec major
Lat dorsi
Subscapularis
Deltoid
Teres Major
36
Q

Which muscles laterally rotate the shoulder?

A

Infraspinatus

Posterior deltoid

37
Q

Where does pec major originate (2 heads) and insert?

A

Origins: clavicular head = anterior surface of medial clavicle, sternal head = sternum and upper 6 costal cartilages
Insertion of both = lateral lip of bicipital groove

38
Q

Where does latissimus dorsi originate and insert?

A

Origin: spines of T7-12, lumbar fascia, posterior third of iliac crest
Insertion: intertubercular groove of humerus

39
Q

Where does pec minor originate and insert?

A

Origin: anterior ribs 3-5
Insert: coracoid process

40
Q

What is the innervation of pec major?

A

Clavicular head: lateral pectoral nerve (C5-6)

Sternal head: medial pectoral nerve (C7-T1)

41
Q

What is the innervation of lat dorsi?

A

Thoracodorsal nerve (from posterior cord of brachial plexus)

42
Q

What does suprascapular nerve innervate?

Where does it come from?

A

Supraspinatus and infraspinatus

Branches from upper trunk of brachial plexus

43
Q

What does the axillary nerve innervate (motor and sensory)?

Where does it come from?

A

Motor: deltoid, teres minor +/- long head of triceps (controversial)
Sensory: regimental patch
Branch of the posterior cord of brachial plexus

44
Q

What do the two branches of the subscapular nerve innervate?

A

Upper branch: upper portion of subscapularis

Lower branch: lower portion of subscap, teres major

45
Q

What is the origin, insertion, action and innervation of teres minor?

A

Origin: dorsal aspect of lateral border of scapula
Insertion: inferior of GT of humerus
Action: lateral rotation of humerus
Innervation: Axillary nerve

46
Q

What is the origin, insertion, action and innervation of supraspinatus?

A

Origin: supraspinous fossa
Insertion: superior of GT of humerus
Action: initiates shoulder abduction
Innervation: suprascapular nerve

47
Q

What is the origin, insertion, action and innervation of infraspinatus?

A

Origin: infraspinous fossa
Insertion: middle of GT of humerus
Action: external rotation of humerus
Innervation: suprascapular nerve

48
Q

What is the origin, insertion, action and innervation of subscapularis?

A

Origin: subscapular fossa
Insertion: LT of humerus
Action: internal rotation and adduction of humerus
Innervation: upper lower subscapular nerves

49
Q

What does the radial head articulate with?

A

Capitulum (humerus) and radial notch (ulna)

50
Q

What are the origin, insertion, main action and innervation of biceps brachii?

A

Origin: short head = coracoid, long head = supraglenoid tubercle
Insertion: radial tuberosity and bicipital aponeurosis (to ulna)
Main action: elbow flexion and forearm supination
Innervation: musculocutaneous nerve (C5-7)

51
Q

What are the origin, insertion, main action and innervation of brachialis?

A

Origin: distal half anterior humeral shaft
Insertion: ulnar tuberosity, coronoid process
Action: elbow flexion
Innervation: musculocutaneous nerve (+/- radial nerve)

52
Q

What are the origin, insertion, main action and innervation of coracobrachialis?

A

Origin: coracoid process
Insertion: anteromedial humeral shaft distal to origin of brachialis
Action: shoulder adduction and flexion
Innervation: musculocutaneous nerve

53
Q

What does the musculocutaneous nerve supply?

A

Motor: biceps brachii, brachialis, coracobrachialis
Sensory: lateral cutaneous nerve of forearm

54
Q

What are the origin, insertion, main action and innervation of brachioradialis?

A

Origin: supracondylar ridge (of humerus)
Insertion: radial styloid
Action: elbow flexion
Innervation: radial nerve

55
Q

What are the origin, insertion, main action and innervation of triceps brachii?

A

Origins: infraglenoid tubercle (long head), posterior humeral shaft above radial groove (lateral head), posterior aspect humeral shaft below radial groove (medial head)
Insertion: olecranon process
Action: elbow extension (+ extension and adduction at shoulder by long head only)
Innervation: radial nerve (+/- axillary to long head)

56
Q

What is PRUJ an articulation between?

A

Radial head with radial notch on proximal ulna and with capitulum on distal humerus

57
Q

What is DRUJ an articulation between?

A

Ulna head with ulnar notch on distal radius and fibrocartilaginous disc

58
Q

What are the attachments of fibrocartilaginous articular disc at distal ulna?

A

Apex to ulnar styloid, base to ulnar notch

59
Q

For pronator teres:

Origin? Insertion? Action? Innervation?

A

Origin: common flexor origin (medial humeral epicondyle) and coronoid process of ulna
Insertion: midshaft radius
Action: forearm pronation
Innervation: median nerve

60
Q

For pronator quadratus:

Attachments? Action? Innervation?

A

Attachments: anterior distal radius and ulna
Action: forearm pronation
Innervaton: median nerve

61
Q

Which muscles produce forearm supination? (2)

A

Biceps brachii

Supinator

62
Q

For supinator:

Origin? (2) Insertion? Action? Innervation?

A

Origin: lateral epicondyle and supinator crest on ulna
Insertion: proximal radial shaft
Action: forearm supination
Innervation: radial nerve

63
Q

How many forearm muscles in superficial anterior compartment? Where do they all (at least partially) originate?

A

4 (pronator teres, FCR, palmaris longus, FCU)

Origin = common flexor origin (medial humeral epicondyle)

64
Q

Where does FCR originate, insert, what action(s), innervation?

A 
Origin = common flexor origin (medial humeral epicondyle) 
Insertion = MC 2 and 3
Action = wrist flexion and abduction
innervation = median nerve
65
Q

For FCU:

Origin? (2) Insertion? Action? Innervation?

A

From common flexor origin (medial humeral epicondyle) and posterior ulna to hook of hamate and base of 5th MC (via pisiform bone)
Flexes and adducts the wrist
innervation = median nerve

66
Q

Where does palmaris longus originate, insert, what action(s), innervation?

A

Origin: common flexor origin (medial humeral epicondyle)
Insertion: flexor retinaculum
Wrist flexion
Median nerve

67
Q

How many forearm muscles in intermediate flexor compartment?

A

1 (FDS)

68
Q

For FDS:

Origin? (3) Insertion? Action? Innervation?

A

Origin: 1 head from common flexor origin (medial humeral epicondyle) and coronoid process, other head from anterior oblique line of radius
Insertion: 4 tendons - one for base of middle phalanges of each finger
Actions: wrist flexion, finger MCPJ and PIPJ flexion
Innervation: median nerve

69
Q

How many forearm muscles in deep flexor compartment?

A

3 (FDP, FPL, pronator quadratus)

MRCS Anatomy (3 decks)

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