Upper limb anatomy Flashcards
joints of upper limb?
sternoclavicular acromioclavicular glenohumeral elbow proximal and distal radioulnar joints radiocarpal joint first CMC joint MCP joint PIP joint DIP joint
what is subluxation
partial dislocation
what is disclocation
where articular surfaces do not overlap at all
what ligaments does the elbow have
lateral (radial) collateral
medial (ulnar) collateral
annular
muscles of shoulder girdle?
trapezius deltoid latissimus dorsi levator scapulae teres pectoralis major and minor serratus anterior rhomboid major and minor rotator cuff
what is deltoid innervated by
axillary nerve
what is pectoralis major innervated by
medial pectoral and lateral pectoral
what is pectoralis minor innervated by
medial pectoral
what is serratus anterior innervated by
long thoracic
what is levator scapulae innervated by
dorsal scapular
what is rhomboid major and minor innervated by
dorsal scapular
what is teres innervated by
lower subscapular
what is latissimus dorsi innervated by
thoracodorsal
what is trapezius innervated by
accessory nerve
where are the rotator cuff muscles found
anterior, superior and posterior to shoulder and are stabilisers
what are the 4 rotator cuff muscles
supraspinous
infraspinous
teres minor
subscapularis
what artery, nerve and vein supplies anterior arm and what are the muscles in it and what does it do
brachial artery/vein and musculocutaneous
biceps brachii, coracobrachialis, brachialis
flexion of arm and forearm, biceps brachii supinates forearm
what artery, nerve and vein supplies posterior arm and what are the muscles in it and what does it do
profunda brachii artery (ulnar collateral) and vein and radial nerve
triceps brachii
extend arm and forearm
artery, vein, nerve and function of anterior forearm
radial/ulnar artery and venae comitantes
median and ulnar supplies flexor carpi ulnaris and medial half flexor digitorum profundus
flex wrist and digits, abduction/adduction wrist, pronate forearm
artery, vein, nerve and function of posterior forearm
interosseous artery and venae comitantes
radial nerve
extend wrist and digits, abduction/adduction wrist, supinate forearm
superficial muscles of anterior forearm
pronator teres, flexor carpi radialis, flexor carpi ulnaris, palmaris longus
intermediate muscles of anterior forearm
flexor digitorum superficialis
deep muscles of anterior forearm
flexor pollicis longus, flexor digitorum profundus, pronator quadratus
superficial muscles of posterior forearm
brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digiti minimi, extensor carpi ulnaris, extensor digitorum, anconeus
deep muscles of posterior forearm
supinator, extensor pollicis brevis, extensor indicis, extensor pollicis longus, abductor pollicis longus
what artery and motor nerve supplies the hand
superficial (ulnar) and deep (radial) palmar arches
median and ulnar
what muscles are in thenar eminence and what nerve supplies them
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
median
what muscles are in the hypothenar eminence and what nerve supplies them
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
ulnar nerve
what do the dorsal/palmar interossei do and what innervates them
dorsal abducts digits and palmar adducts digits
ulnar nerve
what supplies medial palmar/dorsal hand, little finger and 1/2 ring finger
ulnar nerve (C8-T1)
what supplies lateral palmar hand and thumb, index, middle and 1/2 ring finger
median nerve (C6-C8)
what supplies dorsolateral hand
radial nerve (C6-C8)
what supplies anteromedial sensory supply to wrist
medial cutaneous nerve of forearm
what supplies anterolateral sensory supply to wrist
lateral cutaneous nerve of forearm
what supplies posterior sensory supply to wrist
posterior cutaneous nerve of forearm
describe carpal tunnel and contents
between carpal bones and flexor retinaculum median nerve flexor digitorum superficialis flexor digitorum profundus flexor pollicis longus
the axillary artery has a scapular anastomosis. what are the 3 branches
suprascapular
dorsal scapular
circumflex scapular
the axillary vein is a continuation of the ___ vein and becomes the axillary vein at ____
brachial vein
lower border of teres major
where can pulsations of the subclavian artery be palpated
where the artery crosses the first rib
what muscle forms a large part of the anterior wall of the axilla
pectoralis major
what muscle contributes to the posterior wall of the axilla
teres major
what do humeral lymph nodes receive lymph from
most of upper limb
what do subscapular lymph nodes get lymph from
scapular region
what do pectoral lymph nodes get lymph from
breast
what do the pectoral, subscapular and humeral lymph nodes drain to
basal lymph nodes, draining to central, then apical, then thoracic duct
what are the roots of the brachial plexus made up of and where are they located
C5-T1
between anterior and middle scalene muscles in root of neck
what are the trunks of the brachial plexus and root combinations
superior - C5-6
middle - C7
inferior - C8-T1
what are the divisions of the brachial plexus and where are they located
each trunk divides into ant and post cords
located immediately posterior to subclavian vessels in root of neck
what is the lateral cord of the brachial plexus made up of
anterior divisions of superior and middle trunks
what is the medial cord of the brachial plexus made up of
direct continuation of anterior inferior trunk
what is the posterior cord of the brachial plexus made up of
posterior divisions of all 3 trunks
the ulnar nerve comes from what cord
medial
the musculocutaneous nerve comes from what cord
lateral
the radial and axillary nerve comes from what cord
posterior
the median nerve comes from what cord
formation of medial and lateral cords
where do the cords of the brachial plexus lie
axillary artery, distal to first rib
where does the ulnar nerve pass
posteriorly into medial of arm
where does the musculocutaneous nerve go
enters coracobrachialis but also supplies biceps brachii and brachialis
where do axillary and radial nerve pass
posterior compartment arm
axillary nerve superior andwraps around posterior surgical neck of humerus
radial nerve wraps round posterior mid shaft of humerus
muscles of deltoid and action
posterior - extension shoulder
middle - adduction when >15
anterior - shoulder flexion
action of trapezius
ascending - scapular depression
middle - retraction of scapula
descending - elevation of scapula
all together is sup rotation glenoid fossa
action of levator scapulae
elevates scapula and inferior rotation of glenoif fossa
action of rhomboid major/minor
retraction of scapula/inferior glenoid fossa rotation
action of supraspinatus
stabilise head humerus
furst 15 degrees abduction
action of infraspinatus
stabilise head humerus
lateral rotation of shoulder
action of teres minor
stabilise head humerus
lateral rotation at shoulder
action of subscapularis
stabilise head humerus
medial rotation of shoulder
action of teres major
adduction/medial rotation at shoulder
describe the movement of the scapula with superior rotation of shoulder
scapula is moved superiorly
this is to prevent impongement of greater tubercle and acromion
distal insertions of the rotator cuff muscles
supraspinatus, infraspinatus and teres minor - greater tubercle
subscapularis - lesser tubercle
boundaries of the wquadrangular space?
tere minor
teres major
long head triceps
humerus
what structures pass through the quadrangular space
axillar artery
circumflex humeral artery
prox/distal attachments of the deltoid and its nervous innervation
lateral 1/3 clavicle and inferior scapular spine
deltoid tuberosity
axillary nevre
sensory innervation to posterior aspect of the arm
medial - ant rami C8, T1, T2 via medial cutaneous nerve forearm, medial/posterior cutaneous nerves
lateral - ant rami C5 and C6
describe how the arm is a common site for cardiac referred pain
intercostobrachial nerve and medial and posterior cutaneous nerves of arm and medial cutaneous nerve of forearm enter spinal cord at same point as cardiac sensory
triceps brachii - attachments, nerve supply, action
attachments - infraglenoid tubercle, superior and inferior to radial groove humerus
form triceps tendon, inserting on olecranon process
radial nerve
weak extension of shoulder and extension at elbow
what does the axillary nerve supply
deltoid
teres minor
skin innervated by axillary nerve?
badge patch
describe the route of the radial nerve
axilla to posterior arm where it is found in the radial groove of the humerus
supplies triceps brachii and leaves to enter lateral cubital fossa and returns to posterior forearm
what posterior muscle of the forearm is counted but is not technically in the posterior compartment
brachioradialis, innervated by radial nerve
functions in flexion in semi pronated state
nerve supply to posterior muscles of forearm
radial
describe the deep branch of the radial nerve
radial nerve branches just anteiror to lateral epicondyle
passes into post compartment and winds round neck of radius and passes through supinator
renamed to posterior interosseous nerve and supplies posterior compartment of the forearm
arterial supply to posterior compartment
posterior interosseous artery, branch of ulnar
point of origin of the superficial muscles of the posterior forearm
lateral epicondyle
point of origin for the deep muscles of the posterior forearm
radius, ulna and interosseous membrane
superficial muscles of the posterior forearm
brachioradialis extensor carpi radialis longus extensor carpi radialis brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris
deep muscles of the posterior forearm
supinator extensor pollicis longus extensor pollicis brevis abductor pollicis longus extensor indicis
function of extensor indicis?
extends index finger
what muscles extend thumb
extensor pollicis longus/brevis
what muscle abducts thumb
abductor pollicus longus
what muscles extend wrist
extensor carpi ulnaris
extensor carpi radialis
what muscles extend the digits
extensor digitorum
extensor digiti minimi
what holds the extensor muscles/tendons in place
extensor retinaculum
