Upper Limb (from handbook) Flashcards
what are the movements of the scapula?
- protraction (extends upper limb)
- retraction (squares shoulders)
- elevation (shruggs shoulders)
- depression (lowers shoulders)
- rotation (tilts glenoid fossa cranially to aid elevation)
what is the pectoral girdle?
connects your upper limbs to the bones along the axis of your body
what are the large superficial muscles of the posterior pectoral girdle?
- trapezius
- latissimus dorsi
what are the muscles of the anterior pectoral girdle?
- pectoralis major
- pectoralis minor
- serratus anterior
what is the attachment of latissimus dorsi?
anterior aspect of proximal humerus
what is the attachment of latissimus dorsi?
anterior aspect of proximal humerus
what are the smaller deeper muscles of the posterior pectoral girdle?
- levator scapulae
- rhomboid major
- rhomboid minor
what do the posterior pectoral girdle muscles attach?
scapula to vertebral column
- except latissimus dorsi (inserts onto humerus)
what are the muscles of the posterior pectoral girdle innervated by?
branches of the brachial plexus
trapezius: spinal root of CN XI
latissimus dorsi: thoracodorsal nerve
which muscles attach the scapula to the humerus?
- deltoid
- supraspinatus
- infraspinatus
- subscapularis
- teres minor
- teres major
what do the scapulo-humeral muscles do and where do they lie?
- move and stabilise shoulder joint
- deep to posterior scapular muscles (except deltoid)
what are the rotator cuff muscles and what do they do?
- supraspinatus
- infraspinatus
- subscapularis
- teres minor
- stabilise the shoulder joint
what are the posterior arm muscles?
triceps brachii
- long head
- lateral head
- medial head
what is the function of the anterior compartment of the arm?
- extends elbow
- (long head) extends shoulder joint
what is the posterior compartment of the arm innervated by?
radial nerve
what are the boundaries of the axilla?
anterior - pectoralis major & minor posterior - subscapularis, teres major, latissimus dorsi lateral - upper humerus medial - serratus anterior, chest wall apex - 1st rib, clavicle, scapula base - skin, fascia
what does the axilla contain?
- lymph nodes
- axillary artery
- axillary vein
- brachial plexus
what is the axillary artery a continuation of and what does it continue as?
- subclavian
- brachial
what are the roots of the brachial plexus and where are they found?
C5-T1
- neck
what are the trunks of the brachial plexus and where are they found?
superior - C5&6
middle - C7
inferior - C8 & T1
- neck
what are the divisions of the trunks of the brachial plexus and where are they found?
- anterior
- posterior
- under the clavicle
what are the muscles of the anterior compartment of the arm?
- biceps brachii
- brachialis
- coracobrachialis
what are the functions of the anterior compartment of the arm?
flexion
what is the anterior compartment of the arm innervated by?
musculocutaneous nerve
what are the borders of the cubital fossa?
lateral - brachioradialis
medial - pronator teres
superior (base) - imaginary line between medial and lateral epicondyles of humerus
apex - ‘points’ towards forearm and hand
what are the contents of the cubital fossa?
- tendon of biceps brachii
- bicipital aponeurosis (from biceps tendon)
- brachial artery
- radial artery
- ulnar artery
- radial nerve
- median nerve
what are the terminal branches of the brachial artery?
- radial
- ulnar
what are the superficial muscles of the anterior forearm?
lateral -> medial
- pronator teres
- flexor carpi radialis
- palmaris longus
- flexor carpi ulnaris
where do the superficial muscles of the anterior forearm originate?
medial epicondyle of the
humerus
what are the middle muscles of the anterior forearm?
flexor digitorum superficialis
what are the deep muscles of the anterior forearm?
- Flexor digitorum profundus
- Flexor pollicis longus
- Pronator quadratus
what is the action of the anterior forearm muscles?
- flexion
except:
pronator teres - pronator of proximal radioulnar joint
pronator quadratus - pronator of distal radioulnar joint
what are the anterior forearm muscles innervated by?
- median nerve
except:
flexor carpi ulnaris - ulnar nerve
medial 1/2 flexor digitorum profundus - ulnar nerve
what are the borders of the carpal tunnel?
floor & sides - carpal bones
roof - flexor retinaculum
what are the contents of the carpal tunnel?
- tendons of FDS. FDP, FPL
- median nerve
which muscles of the anterior forearm are prime flexors of the wrist?
- flexor carpi radialis
- flexor carpi ulnaris
- palmaris longus
which muscles of the anterior forearm flex the digits?
- Flexor digitorum superficialis
- Flexor digitorum profundus
- Flexor pollicis longus
what are the 4 groups of intrinsic muscles of the hand (and the extra muscle)?
- thenar eminence
- hypothenar eminence
- lumbricals
- interossei
- adductor pollicis
how many thenar eminence muscles are there and what are they innervated by?
3
- median nerve
how many hypothenar eminence muscles are there and what are they innervated by?
3
- ulnar nerve
how many lumbrical muscles in the hand are there and what are they innervated by?
4
digits 2 and 3 - median
digits 4 and 5 - ulnar
how many interossei muscles in the hand are there?
7
what are the intrinsic muscles of the hand innervated by?
ulnar & median nerves
what are the muscles of the thenar eminence and what is their insertion?
- flexor pollicis brevis - PP
- abductor pollicis brevis - PP
- oppnens pollicis - 1st metacarpal
how is the adductor pollicis different from the muscles of the thenar eminence?
- lies deep in the palm (not thenar eminence)
- innervated by ulnar nerve
what is the insertion of adductor pollicis?
- 3rd metacarpal
- proximal phalanx of thumb
what are the muscles of the hypothenar eminence and what is their insertion?
- flexor digiti minimi - PP
- abductor digiti minimi - PP
- opponens digiti minimi - 5th metacarpal
describe the passage of the lumbrical muscles of the hand
- arise from tendons of FDP
- travel along lateral aspects of digits 2-5
- insert onto dorsal aspects
what do the lumbricals do?
- flex MCP joints
- extend IP joints
what are the subdivisions of the interossei muscles and how many are in each?
palmar - 3
dorsal - 4
what are the actions of the interossei muscles?
palmar - adduct
dorsal - abduct
(PAD-DAB)
- extension of fingers at IP joints
how would you test the dermatomes of the upper limb?
C5 - upper lateral arm C6 - thumb C7 - middle finger C8 - medial border of hand T1 - medial border of elbow
what are the superficial muscles of the posterior compartment of the forearm?
lateral -> medial
- Brachioradialis
- Extensor carpi radialis longus
- Extensor carpi radialis brevis
- Extensor digitorum
- Extensor digiti minimi
- Extensor carpi ulnaris
how are the posterior forearm muscles arranged?
- superficial layer
- deep layer
what is the action of most of the posterior forearm muscles and what are the exceptions?
extensors of the wrist, digits or thumb except: - brachioradialis - supinator - abductor pollicis longus
what are the posterior forearm muscles innervated by?
radial nerve
what is the origin of the posterior forearm muscles?
lateral epicondyle of the humerus
common extensor origin
what are the deep muscles of the posterior forearm?
lateral -> medial
- Supinator
- Abductor pollicis longus
- Extensor pollicis brevis
- Extensor pollicis longus
- Extensor indicis
what is the attachment of the deep posterior forearm muscles?
proximally to the forearm bones and the interosseous membrane
(except supinator)
which deep muscles of the posterior forearm are not extensors?
supinator: - supinates forearm and hand - attaches to humerus abductor pollicis longus - abducts thumb - inserts onto 1st metacarpal
which superficial posterior forearm muscles are not extensors?
brachioradialis
- lies on boundary between posterior and anterior compartments
- weak flexor of elbow joint
what is the anatomical snuffbox?
- triangular-shaped depression on the lateral aspect of the wrist, at the base of the thumb
- seen when the thumb is extended.
what are the boundaries of the anatomical snuffbox?
medial - tendon of EPL
lateral - tendons of EPB and APL
why is the anatomical snuffbox a clinically important region?
- scaphoid lies in floor
- radial artery
- cephalic vein (cannulation)
what are the areas of skin supplied by the peripheral nerves of the upper limb?
median: - palmar surface of the middle finger ulnar: - medial border of the hand radial: - lateral dorsum of the hand
