UPPER LIMB: BONES & MUSCLES

Question 1

Where does the axillary artery begin, and its general course?

Answer 1

From the subclavian artery, the axillary art. begins at the lateral border of the 1st rib

Then continues as the brachial artery @ lower border of the teres major

Question 2

What nerve roots comprise of the brachial plexus?

Answer 2

C5 to T1

Question 3

Significance of Brachial Plexus Lateral and Medial Cords

Answer 3

Form an iconic N/M shape signifying

```
lateral
musculocutaneous n
median n
ulnar n.
(medial)
~~~

Question 4

What muscles make up the rotator cuff

Answer 4

Supraspinatus, Infraspinatus,Teres minor, and Subscapularis

The muscles arise from the scapula and connect to the head of the humerus, forming a cuff around the glenohumeral (GH) joint

Question 5

Venous drainage of the upper limb

Answer 5

cephalic vein (radial side)

basilic vein (ulnar side)

*median cubital vein

Question 6

Joints associated with the shoulder

Answer 6

STERNOCLAVICULAR JOINT = synovial saddle

ACROMIOCLAVICULAR JOINT = plane synoyvial

Question 7

Which part of the clavicle is the weakest?

Answer 7

middle 3rd = most #

dt weakest junction

Question 8

Significance of abduction and joints involved

Answer 8

First 30º = glenohumeral

Beyond 30º = scapular elevation and lateral rotation

Question 9

Muscles of Scapular Elevation

Answer 9

Trapezius
Levator scapulae
Rhomboid

Question 10

Muscles of Scapular Depression

Answer 10

Latissimus dorsi

Serratus anterior

Question 11

Muscles of Scapular Protraction

Answer 11

Serratus anterior + pectorals

Question 12

Muscles of Scapular Retraction

Answer 12

Trapezius and Rhomboids

Question 13

Muscles of Scapular Lateral Rotation

Answer 13

Trapezius and serratus anterior

Question 14

Muscles of Scapular Medial Rotation

Answer 14

Gravity
Levator scapulae
Rhomboids
Pecs. Mn.

Question 15

Actions of Latissimus dorsi

Answer 15

movements on the shoulder joint; internal rotation, adduction and extension of the arm.

Question 16

Actions and innervation of Infraspinatus

Answer 16

Infraspinatus is one of the four rotator cuff muscles, alongside subscapularis, teres minor and supraspinatus muscles.

As a part of the rotator cuff muscles, the main function of infraspinatus muscle is external rotation of the humerus

(Suprascapular nerve (C5, C6))

Question 17

Actions and innervation of supraspinatus

Answer 17

Arm abduction

Suprascapular nerve (C5, C6)

Question 18

Actions and innervation of Teres Mn

Answer 18

Shoulder joint: Arm external rotation, arm adduction;

Axillary nerve (C5, C6)

Question 19

Actions and innervation of Subscapularis

Answer 19

Shoulder joint: Arm internal rotation

Upper and lower subscapular nerves (C5 - C6)

Question 20

Humeral Anatomical Neck Vs Surgical Neck

Answer 20

ANATOMICAL NECK = next to HUMERAL HEAD

SURGICAL NECK = NEXT TO SHAFT, and INTERTUBERCULAR GROOVE
* most frequently fractured site of the proximal humerus, putting the axillary nerve and posterior circumflex humeral branch of the axillary artery at risk

Question 21

What is the function of the glenoid labrum

Answer 21

It forms a rim around the glenoid fossa

• deepens the fossa
• shock abs.
• attachments for ligaments

Question 22

What are the ligaments of the glenohumeral joint

Answer 22

1. CORACOACROMIAL LIGAMENT
2. CORCACOHUMERAL LIGAMENT = prevents superior displacement of the humeral head
3. GLENOHUMERAL LIGAMENTs = anterior stability
4. Transverse Humeral Ligament = associated w/ bicipital groove and forms its roof

Question 23

What are the 2 main bursa in the shoulder?

Answer 23

1. SUBACROMIAL BURSA - found in btween infra/supraspinatus and the deltoid
   => provides gliding mechanism btween rotator cuff and coracoacromial arch

• rotator cuff injury / subacromial bursitis
  2. SUBSCAPULAR BURSA

Question 24

Primary function of the rotator cuff muscles (aside from movement)?

Answer 24

Centralise Humeral Head

Question 25

Movements of the deltoid

Answer 25

ANTERIOR = +pec maj., FLEXION and internal rot. MIDDLE = ABDUCTION POSTERIOR = EXTENSION. and ext. rotation

Question 26

Deltoid and nerve significance

Answer 26

AXILLARY N. (C5,C6) supplies thus COMMON ENTRAPMENT during SHOULDER DISLOCATION = regimental badge

Question 27

The distal attachments of pec maj.

Answer 27

LATERAL LIP OF HUMERUS and INTERTUBERCULAR GROOVE

Question 28

Actions of pec maj.

Answer 28

1. Shoulder flexion | 2. Humeral adduction. and internal rot.

Question 29

Significance of Winging Scapula

Answer 29

dt dmg. to LONG THORACIC N. (from mastectomy coommonly) innervation to seratus anterior = malfunction to scapula protraction to posterior rib cage

Question 30

Trapezius sectiions

Answer 30

SUPERIOR = ELEVATIION MIDDLE = RETRACT NFERIOR = DEPRESS

Question 31

What is the trapezius' innervation and which skull foramen does it pass?

Answer 31

ACCESSORY N - XI via JUGULAR FORAMEN

Question 32

Major muscles of the anterior upper arm

Answer 32

BICEPS BRACHII BRACHIALIS CORACACOBRACHIALIS +musculocutaneous nerve (C5, C6)

Question 33

Actions of biceps brachii

Answer 33

flexion of elbow | arm supination

Question 34

The x head of the biceps originates from the y process of the scapula

Answer 34

Short head originates coracacoid process

Question 35

The x head of the biceps originates from the y tubercle of the scapula. its tendon passes through the z of the humerus?

Answer 35

Long head originates from infraglenoid tubercle, with the tendon passing the bicipital groove

Question 36

Where does the brachialis insert into?

Answer 36

ulna: coronoid process and tuberosity

Question 37

What is the main nerve of the anterior compartment of the arm?

Answer 37

(C5, C6) | Musculocutaneous supplies all muscles within the anterior compartment

Question 38

Progression of the musculocutaneous nerve

Answer 38

(C5-C6) Enters arm perforating coracobrachialis, descening between biceps brachii and brachialis. Branches off as lateral cutaneous nerve of forearm

Question 39

Major muscles of the posterior upper arm

Answer 39

Radial nerve (C6, C7, C8) - a radiant gate TRICEPS - LATERAL HEAD TRICPES - LONG HEAD => common tendon of triceps inserts into olecranon process of the ulna ANCONEUS

Question 40

Which head of the triceps attached onto the. infra-glenoid tubercle of the scapula?

Answer 40

Long head

Question 41

What is the action of the triceps?

Answer 41

Elbow extension

Question 42

Innervation of the triceps

Answer 42

Radial nerve (C6, C7, C8).

Question 43

Innervation of the posterior compartment of the arm

Answer 43

Radial nerve (C6, C7, C8).

Question 44

Which vein lies in the roof of the antecubital fossa?

Answer 44

MEDIAN CUBITAL VEIN anterior to brachial art, and associated medial and lateral cut. nerves, and basilic and cephalic veins

Question 45

What sides are the basilic and cephalic veins on?

Answer 45

BASILIC = medial/ulnar CEPHALIC = lateral/radial

Question 46

WHAT TYPE OF JOINT IS the elbow joint?

Answer 46

Synovial hinge

Question 47

What inflammation/conditions are associated with both medial and lateral epicondyles?

Answer 47

TENNIS ELBOW = LATERAL EPICONDYLITIS GOLFER'S ELBOW = MEDIAL EPICONDYLITIS +Student's Elbow = Olecranon Bursitis

Question 48

What ligament holds the head of the radius in contact with the radial notch of the ulna?

Answer 48

ANNULAR LIGAMENT

Question 49

Supination and pronation are the movements of the x joints (also joint type of x)

Answer 49

proximal radio-ulnar joints (synovial pivot)

Question 50

What muscles are involved in sup/pron

Answer 50

SUP: 1. Supinator muscle 2. Biceps brachii PRON.: 1. PRONATOR TERES 2. PRONATOR QUADRATUS